CHRISTINA MARIE MANNIX MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

First Name

CHRISTINA

Middle

MARIE

Last Name

MANNIX

Suffix

Business Name

CHRISTINA MARIE MANNIX MD

Original Issue Date

04/11/2003

Effective Date

07/14/2014

Expiration Date

07/31/2017

City

WATERLOO

State

Zip

62298

County

MONROE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017