MICHAEL LOPEZ MANGONON DO - Medical Doctor License in New York | # 036130394

MICHAEL LOPEZ MANGONON DO

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036130394

License Status

NOT RENEWED

Business

N

Title

DO

First Name

MICHAEL

Middle

LOPEZ

Last Name

MANGONON

Business Name

MICHAEL LOPEZ MANGONON DO

Original Issue Date

05/21/2012

Effective Date

05/21/2012

Expiration Date

07/31/2014

State

NY

Ever Disciplined

N

LastModifiedDate

11/17/2014