JENNIFER L MANGINO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

MANGINO

Business Name

JENNIFER L MANGINO

Original Issue Date

02/27/2007

Effective Date

02/27/2007

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011