TONY MAMMEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

TONY

Last Name

MAMMEN

Suffix

Business Name

TONY MAMMEN MD

Original Issue Date

08/08/2008

Effective Date

08/08/2008

Expiration Date

07/31/2011

City

ORLAND PARK

State

Zip

60467

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011