B THEO MELLION MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036095084

License Status

NOT RENEWED

Business

First Name

B THEO

Last Name

MELLION

Suffix

Business Name

B THEO MELLION MD

Original Issue Date

03/18/1997

Effective Date

03/18/1997

Expiration Date

07/31/2005

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

10/09/2006