DAVID BRUCE MANSUR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

CANCELLED

Business

First Name

DAVID

Middle

BRUCE

Last Name

MANSUR

Suffix

Business Name

DAVID BRUCE MANSUR MD

Original Issue Date

05/15/1998

Effective Date

05/15/1998

Expiration Date

07/31/2002

City

LA GRANGE

State

Zip

60525

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006