GENESIS T MANCHA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036165329

License Status

ACTIVE

Business

Title

First Name

GENESIS

Middle

Last Name

MANCHA

Business Name

GENESIS T MANCHA MD

Original Issue Date

06/21/2023

Effective Date

06/21/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

06/12/2023