MICHAEL N MANGOLD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027400

License Status

EXPIRED

Business

First Name

MICHAEL

Middle

Last Name

MANGOLD

Business Name

MICHAEL N MANGOLD

Original Issue Date

07/11/1991

Effective Date

07/11/1991

Expiration Date

07/10/1994

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006