DZUNG DUC-TIEN MANG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

CANCELLED

Business

First Name

DZUNG

Middle

DUC-TIEN

Last Name

MANG

Suffix

Business Name

DZUNG DUC-TIEN MANG MD

Original Issue Date

12/07/1999

Effective Date

12/07/1999

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006