MATILDA M MENGIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

First Name

MATILDA M

Last Name

MENGIS

Suffix

Business Name

MATILDA M MENGIS MD

Original Issue Date

01/09/1995

Effective Date

01/09/1995

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006