THOMAS J MANGO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

Title

First Name

THOMAS

Middle

Last Name

MANGO

Business Name

THOMAS J MANGO MD

Original Issue Date

07/26/1995

Effective Date

12/15/2014

Expiration Date

07/31/2017

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017