MICHAEL SHAWN MENGARELLI DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

ACTIVE

Business

Title

First Name

MICHAEL

Middle

SHAWN

Last Name

MENGARELLI

Business Name

MICHAEL SHAWN MENGARELLI DO

Original Issue Date

12/14/2021

Effective Date

05/25/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/25/2023