NISHA MANGALAT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

Title

First Name

NISHA

Last Name

MANGALAT

Business Name

NISHA MANGALAT MD

Original Issue Date

06/11/2014

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

SAINT LOUIS

State

Zip

63124

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021