ANGELA MENNICKE LOPEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

Title

First Name

ANGELA

Middle

MENNICKE

Last Name

LOPEZ

Business Name

ANGELA MENNICKE LOPEZ MD

Original Issue Date

09/17/2012

Effective Date

09/17/2012

Expiration Date

07/31/2014

City

CULVER CITY

State

Zip

90230

County

CALIFORNIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014