MANISH MATHUR Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

First Name

MANISH

Last Name

MATHUR

Business Name

MANISH MATHUR

Original Issue Date

06/22/2000

Effective Date

07/20/2023

Expiration Date

07/31/2026

City

STAUNTON

State

Zip

62088

County

MACOUPIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/20/2023