RICHARD JOSEPH MELLITT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

CANCELLED

Business

First Name

RICHARD

Middle

JOSEPH

Last Name

MELLITT

Suffix

Business Name

RICHARD JOSEPH MELLITT MD

Original Issue Date

07/16/1998

Effective Date

07/16/1998

Expiration Date

07/31/2002

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006