BIPLAB KUMAR MALO - Dentist License in Illinois | # 137000563

BIPLAB KUMAR MALO

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000563

License Status

NOT RENEWED

Business

N

First Name

BIPLAB

Middle

KUMAR

Last Name

MALO

Business Name

BIPLAB KUMAR MALO

Original Issue Date

08/06/2002

Effective Date

07/24/2006

Expiration Date

09/30/2009

State

IL

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

N

LastModifiedDate

11/04/2009