MARCONI D DELADISMA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

ACTIVE

Business

Title

First Name

MARCONI

Middle

Last Name

DELADISMA

Business Name

MARCONI D DELADISMA MD

Original Issue Date

01/10/2006

Effective Date

06/17/2023

Expiration Date

07/31/2026

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/17/2023