JAMES JAY MANGLE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

NOT RENEWED

Business

First Name

JAMES JAY

Last Name

MANGLE

Business Name

JAMES JAY MANGLE

Original Issue Date

08/26/1982

Effective Date

08/26/1982

Expiration Date

09/30/1984

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005