MIRIAM MANGLANO TIERNEY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102657

License Status

NOT RENEWED

Business

First Name

MIRIAM

Last Name

MANGLANO TIERNEY

Business Name

MIRIAM MANGLANO TIERNEY

Original Issue Date

06/09/2000

Effective Date

06/09/2000

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60655

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006