RICHARD D COLAVITA MD Medical Doctor License verification

Business Entity

INOPERATIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

INOPERATIVE

Business

First Name

RICHARD D

Last Name

COLAVITA

Suffix

Business Name

RICHARD D COLAVITA MD

Original Issue Date

10/11/1985

Effective Date

10/11/1985

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006