JULIAN W MALL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000042

License Status

EXPIRED

Business

First Name

JULIAN

Middle

Last Name

MALL

Business Name

JULIAN W MALL

Original Issue Date

01/15/1997

Effective Date

01/15/1997

Expiration Date

04/12/1997

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/23/2006