VINCENT GIANNI VACKETTA Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****46

License Status

ACTIVE

Business

First Name

VINCENT

Middle

GIANNI

Last Name

VACKETTA

Business Name

VINCENT GIANNI VACKETTA

Original Issue Date

08/16/2023

Effective Date

12/23/2024

Expiration Date

01/31/2027

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/23/2024