AIMEE LUNA MANDAPAT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

Title

First Name

AIMEE

Middle

LUNA

Last Name

MANDAPAT

Business Name

AIMEE LUNA MANDAPAT MD

Original Issue Date

04/09/2009

Effective Date

04/09/2009

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011