MARY ELLEN WALTON CONTI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

Title

First Name

MARY ELLEN

Middle

WALTON

Last Name

CONTI

Business Name

MARY ELLEN WALTON CONTI MD

Original Issue Date

01/01/1997

Effective Date

07/19/2017

Expiration Date

09/30/2020

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021