JESUS A MANTECA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

JESUS A

Last Name

MANTECA

Suffix

Business Name

JESUS A MANTECA MD

Original Issue Date

12/18/1996

Effective Date

12/18/1996

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