ANGELICA MICHELLE MANZUR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

Title

First Name

ANGELICA

Middle

MICHELLE

Last Name

MANZUR

Business Name

ANGELICA MICHELLE MANZUR MD

Original Issue Date

05/26/2015

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60640

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021