MICHAEL MANANSALA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074371

License Status

CANCELLED

Business

Title

First Name

MICHAEL

Last Name

MANANSALA

Business Name

MICHAEL MANANSALA MD

Original Issue Date

06/24/2019

Effective Date

06/24/2019

Expiration Date

06/23/2022

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/29/2019