A K BOBBY MALLIK DMD Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****70

License Status

CANCELLED

Business

First Name

A K

Middle

BOBBY

Last Name

MALLIK

Suffix

DMD

Business Name

A K BOBBY MALLIK DMD

Original Issue Date

07/15/2003

Effective Date

07/15/2003

Expiration Date

09/30/2006

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2006