MAMEYAN DONZO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

ACTIVE

Business

Title

First Name

MAMEYAN

Last Name

DONZO

Business Name

MAMEYAN DONZO MD

Original Issue Date

01/19/2024

Effective Date

01/19/2024

Expiration Date

07/31/2026

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/19/2024