ANDREW MANDEVILLE DAVIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

ACTIVE

Business

First Name

ANDREW

Middle

MANDEVILLE

Last Name

DAVIS

Suffix

Business Name

ANDREW MANDEVILLE DAVIS MD

Original Issue Date

08/22/1983

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023