ASHVARYA MANGLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

ACTIVE

Business

Title

First Name

ASHVARYA

Last Name

MANGLA

Business Name

ASHVARYA MANGLA MD

Original Issue Date

12/05/2011

Effective Date

07/03/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/03/2023