TIMOTHY JOSEPH MANDA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119561

License Status

INACTIVE

Business

First Name

TIMOTHY

Middle

JOSEPH

Last Name

MANDA

Suffix

Business Name

TIMOTHY JOSEPH MANDA MD

Original Issue Date

10/17/2007

Effective Date

04/21/2011

Expiration Date

07/31/2014

City

SAINT LOUIS

State

Zip

63132

County

MISSOURI

Ever Disciplined

LastModifiedDate

04/08/2014