MELISSA DATTALO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

ACTIVE

Business

Title

First Name

MELISSA

Last Name

DATTALO

Business Name

MELISSA DATTALO MD

Original Issue Date

01/31/2025

Effective Date

01/31/2025

Expiration Date

07/31/2026

City

MADISON

State

Zip

53717

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/27/2025