MARK T DONVITO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

ACTIVE

Business

First Name

MARK T

Last Name

DONVITO

Suffix

Business Name

MARK T DONVITO MD

Original Issue Date

08/02/1988

Effective Date

05/19/2023

Expiration Date

07/31/2026

City

MURPHYSBORO

State

Zip

62966

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/19/2023