BRUCE DOUGLAS MALLATT MD - Medical Doctor License in Indiana | # 036057517

BRUCE DOUGLAS MALLATT MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057517

License Status

NOT RENEWED

Business

N

First Name

BRUCE DOUGLAS

Last Name

MALLATT

Suffix

MD

Business Name

BRUCE DOUGLAS MALLATT MD

Original Issue Date

08/21/1978

Effective Date

08/21/1978

State

IN

Ever Disciplined

N

LastModifiedDate

09/20/2006