HALEY KOTH MANNING DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074300

License Status

CANCELLED

Business

Title

First Name

HALEY

Middle

KOTH

Last Name

MANNING

Business Name

HALEY KOTH MANNING DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

LEMONT

State

Zip

60439

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/07/2019