HANISHA MANICKAVASAGAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

ACTIVE

Business

Title

First Name

HANISHA

Last Name

MANICKAVASAGAN

Business Name

HANISHA MANICKAVASAGAN MD

Original Issue Date

12/12/2024

Effective Date

12/12/2024

Expiration Date

07/31/2026

City

WILMINGTON

State

Zip

19807

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/12/2024