MICHAEL DORAN DEVITA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

DORAN

Last Name

DEVITA

Business Name

MICHAEL DORAN DEVITA MD

Original Issue Date

06/20/2014

Effective Date

06/20/2014

Expiration Date

07/31/2017

City

CLAYTON

State

Zip

63105

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017