DALE STEVEN DISALVO MD Medical Doctor License verification

Business Entity

INOPERATIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

INOPERATIVE

Business

Title

First Name

DALE

Middle

STEVEN

Last Name

DISALVO

Business Name

DALE STEVEN DISALVO MD

Original Issue Date

01/31/2020

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

LACEY

State

Zip

98516

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023