DAVID OWEN MANIGOLD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036061968

License Status

NOT RENEWED

Business

First Name

DAVID OWEN

Last Name

MANIGOLD

Suffix

Business Name

DAVID OWEN MANIGOLD MD

Original Issue Date

04/14/1981

Effective Date

05/19/2020

Expiration Date

07/31/2023

City

OTTAWA

State

Zip

61350

County

LA SALLE

Ever Disciplined

LastModifiedDate

11/30/2023