Vermont Board of Medical Practice

License No. Status First Name Middle Name Last Name Business Name Address1 Address2 City/Town State Zip License First Issuance Date License Effective Date License Expiration Primary Practice Location Name Primary Practice Location Address Primary Practice Location City Primary Practice Location State Primary Practice Location Zip Specialty 1 Specialty 2 Specialty 3 Specialty 4 Specialty 5 Specialty 6 Specialty 7 Specialty 8 Specialty 9 Specialty 10 Actions License Type