CHARISSA LYNN MANUAT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

Title

First Name

CHARISSA

Middle

LYNN

Last Name

MANUAT

Business Name

CHARISSA LYNN MANUAT MD

Original Issue Date

05/07/2012

Effective Date

04/16/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020