SHMUEL MANDELBAUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

NOT RENEWED

Business

Title

First Name

SHMUEL

Last Name

MANDELBAUM

Business Name

SHMUEL MANDELBAUM MD

Original Issue Date

07/23/2021

Effective Date

07/23/2021

Expiration Date

07/31/2023

City

MEQUON

State

Zip

53092

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023