MARY JANE NICANDRO MUNGOVAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102152

License Status

NOT RENEWED

Business

First Name

MARY JANE

Middle

NICANDRO

Last Name

MUNGOVAN

Suffix

Business Name

MARY JANE NICANDRO MUNGOVAN MD

Original Issue Date

03/17/2000

Effective Date

03/17/2000

Expiration Date

07/31/2002

City

RENSSELAER

State

Zip

47978

County

INDIANA

Ever Disciplined

LastModifiedDate

10/09/2006