MARJORIE A MALLECK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125023089

License Status

EXPIRED

Business

First Name

MARJORIE

Middle

Last Name

MALLECK

Business Name

MARJORIE A MALLECK

Original Issue Date

08/02/1988

Effective Date

08/02/1988

Expiration Date

08/01/1991

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006