ANDREW MANDEVILLE DAVIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036066445

License Status

ACTIVE

Business

First Name

ANDREW

Middle

MANDEVILLE

Last Name

DAVIS

Suffix

Business Name

ANDREW MANDEVILLE DAVIS MD

Original Issue Date

05/04/1983

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

04/11/2023