DALE STEVEN DISALVO MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036150840

License Status

INACTIVE

Business

Title

First Name

DALE

Middle

STEVEN

Last Name

DISALVO

Business Name

DALE STEVEN DISALVO MD

Original Issue Date

09/25/2019

Effective Date

06/12/2020

Expiration Date

07/31/2023

City

LACEY

State

Zip

98516

Ever Disciplined

LastModifiedDate

04/18/2023