LISA C MAZZULLO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

ACTIVE

Business

First Name

LISA C

Last Name

MAZZULLO

Business Name

LISA C MAZZULLO

Original Issue Date

07/31/1995

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/22/2023