CONNIE M VITALI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

ACTIVE

Business

First Name

CONNIE M

Last Name

VITALI

Suffix

Business Name

CONNIE M VITALI MD

Original Issue Date

07/06/1995

Effective Date

06/27/2023

Expiration Date

07/31/2026

City

SOUTH BELOIT

State

Zip

61080

County

WINNEBAGO

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/27/2023