MELINDA MAE MANTOOTH DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

ACTIVE

Business

Title

First Name

MELINDA

Middle

MAE

Last Name

MANTOOTH

Business Name

MELINDA MAE MANTOOTH DO

Original Issue Date

06/27/2024

Effective Date

06/27/2024

Expiration Date

07/31/2026

City

WAUKEGAN

State

Zip

60085

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2026