GERALD PETER MCMANAMA 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

GERALD

Middle

PETER

Last Name

MCMANAMA

Business Name

GERALD PETER MCMANAMA MD

Original Issue Date

12/28/1999

Effective Date

12/28/1999

Expiration Date

07/31/2002

City

DU QUOIN

State

Zip

62832

County

PERRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006