DANIEL MARK MAMMEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

Title

First Name

DANIEL

Middle

MARK

Last Name

MAMMEL

Business Name

DANIEL MARK MAMMEL MD

Original Issue Date

10/28/2022

Effective Date

10/28/2022

Expiration Date

07/31/2023

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023