ROBERT WALTER MANDAL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

Title

First Name

ROBERT

Middle

WALTER

Last Name

MANDAL

Business Name

ROBERT WALTER MANDAL MD

Original Issue Date

06/19/2003

Effective Date

06/19/2003

Expiration Date

07/31/2008

City

MCHENRY

State

Zip

60050

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020