DEBRA ANN MANDARINO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

Title

First Name

DEBRA ANN

Last Name

MANDARINO

Business Name

DEBRA ANN MANDARINO MD

Original Issue Date

01/18/2018

Effective Date

01/18/2018

Expiration Date

09/30/2020

City

LAKE ZURICH

State

Zip

60047

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021