JESUS A MANTECA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

First Name

JESUS A

Last Name

MANTECA

Suffix

Business Name

JESUS A MANTECA MD

Original Issue Date

10/11/1995

Effective Date

10/11/1995

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60622

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020