VICTORIA LISA CODISPOTI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

ACTIVE

Business

First Name

VICTORIA

Middle

LISA

Last Name

CODISPOTI

Suffix

Business Name

VICTORIA LISA CODISPOTI MD

Original Issue Date

02/19/2003

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

KELL

State

Zip

62853

County

MARION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023