CRYSTAL VAUGHN MANSE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

ACTIVE

Business

Title

First Name

CRYSTAL

Middle

VAUGHN

Last Name

MANSE

Business Name

CRYSTAL VAUGHN MANSE MD

Original Issue Date

03/23/2016

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023