MANISH PRAJWAL MANE MANOHAR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125084456

License Status

ACTIVE

Business

Title

First Name

MANISH

Middle

PRAJWAL

Last Name

MANE MANOHAR

Business Name

MANISH PRAJWAL MANE MANOHAR MD

Original Issue Date

06/24/2024

Effective Date

06/24/2024

Expiration Date

06/23/2027

City

ROCKFORD

State

Zip

61104

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/11/2024