SALLY M MANDICHAK - Medical Doctor License in Virginia | # 188000922

SALLY M MANDICHAK

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000922

License Status

EXPIRED

Business

N

First Name

SALLY

Middle

M

Last Name

MANDICHAK

Business Name

SALLY M MANDICHAK

Original Issue Date

01/08/2021

Effective Date

01/08/2021

Expiration Date

07/08/2021

State

VA

Specialty/Qualifier

Trauma Rotation

Ever Disciplined

N

LastModifiedDate

10/11/2022