MFOWETHU THEOPHILUS LANGENI DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

ACTIVE

Business

Title

First Name

MFOWETHU

Middle

THEOPHILUS

Last Name

LANGENI

Business Name

MFOWETHU THEOPHILUS LANGENI DO

Original Issue Date

07/19/2024

Effective Date

07/19/2024

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61704

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/19/2024