MICHAEL LOPEZ MANGONON DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036130394

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

LOPEZ

Last Name

MANGONON

Business Name

MICHAEL LOPEZ MANGONON DO

Original Issue Date

05/21/2012

Effective Date

05/21/2012

Expiration Date

07/31/2014

City

BROOKLYN

State

Zip

11223

County

NEW YORK

Ever Disciplined

LastModifiedDate

11/17/2014