MARCI MICHELLE MANNA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

Title

First Name

MARCI

Middle

MICHELLE

Last Name

MANNA

Business Name

MARCI MICHELLE MANNA MD

Original Issue Date

08/03/2016

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021