MARK J LANZEROTTE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

MARK J

Last Name

LANZEROTTE

Suffix

Business Name

MARK J LANZEROTTE MD

Original Issue Date

05/04/1995

Effective Date

05/04/1995

Expiration Date

07/31/1996

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020