CONSTANTINE A MANTZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035011

License Status

EXPIRED

Business

First Name

CONSTANTINE

Middle

Last Name

MANTZ

Suffix

Business Name

CONSTANTINE A MANTZ MD

Original Issue Date

06/12/1996

Effective Date

06/12/1996

Expiration Date

06/30/2000

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Radiation Oncology

Ever Disciplined

LastModifiedDate

09/22/2006