MARY JANE NICANDRO MUNGOVAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030461

License Status

EXPIRED

Business

First Name

MARY JANE

Middle

NICANDRO

Last Name

MUNGOVAN

Suffix

Business Name

MARY JANE NICANDRO MUNGOVAN MD

Original Issue Date

06/24/1993

Effective Date

06/24/1993

Expiration Date

06/30/1997

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006