DIANE A DEMALLIE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036091431

License Status

NOT RENEWED

Business

First Name

DIANE A

Last Name

DEMALLIE

Business Name

DIANE A DEMALLIE

Original Issue Date

07/27/1995

Effective Date

07/27/1995

Expiration Date

07/31/1999

City

COLORADO SPRINGS

State

Zip

80960

County

COLORADO

Ever Disciplined

LastModifiedDate

02/26/2021