ERWIN ZETA MANGUBAT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

Title

First Name

ERWIN

Middle

ZETA

Last Name

MANGUBAT

Business Name

ERWIN ZETA MANGUBAT MD

Original Issue Date

02/28/2014

Effective Date

04/29/2014

Expiration Date

07/31/2017

City

LOCKPORT

State

Zip

60441

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017