MANGALA P KUMAR 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

First Name

MANGALA

Middle

Last Name

KUMAR

Suffix

Business Name

MANGALA P KUMAR MD

Original Issue Date

05/07/1985

Effective Date

06/06/2011

Expiration Date

07/31/2014

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020