MARK C LAVIZZO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

ACTIVE

Business

First Name

MARK

Middle

Last Name

LAVIZZO

Business Name

MARK C LAVIZZO

Original Issue Date

06/29/2001

Effective Date

04/15/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/15/2023