ASHLEY SHAMIKA MALLORY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069126

License Status

CANCELLED

Business

Title

First Name

ASHLEY

Middle

SHAMIKA

Last Name

MALLORY

Business Name

ASHLEY SHAMIKA MALLORY MD

Original Issue Date

07/08/2019

Effective Date

07/08/2019

Expiration Date

11/23/2019

City

CHICAGO

State

Zip

60623

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/08/2019