BRUCE A MALLIN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036083939

License Status

INACTIVE

Business

First Name

BRUCE A

Last Name

MALLIN

Suffix

Business Name

BRUCE A MALLIN MD

Original Issue Date

01/25/1992

Effective Date

01/25/1992

Expiration Date

07/31/1996

City

PHOENIX

State

Zip

85006

County

ARIZONA

Ever Disciplined

LastModifiedDate

09/20/2006