VITALI KONONOV MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

First Name

VITALI

Last Name

KONONOV

Suffix

Business Name

VITALI KONONOV MD

Original Issue Date

01/10/2011

Effective Date

07/11/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60601

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017