MICHAEL EMMANUEL MANDIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

EMMANUEL

Last Name

MANDIS

Suffix

Business Name

MICHAEL EMMANUEL MANDIS MD

Original Issue Date

08/12/2004

Effective Date

06/28/2023

Expiration Date

07/31/2026

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/28/2023