MARK J LANZEROTTE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

ACTIVE

Business

First Name

MARK J

Last Name

LANZEROTTE

Suffix

Business Name

MARK J LANZEROTTE MD

Original Issue Date

05/04/1995

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/10/2023