LARISSA RAE PAVONE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

ACTIVE

Business

Title

First Name

LARISSA

Middle

RAE

Last Name

PAVONE

Business Name

LARISSA RAE PAVONE MD

Original Issue Date

05/06/2010

Effective Date

05/10/2023

Expiration Date

07/31/2026

City

WHEATON

State

Zip

60187

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/10/2023