MATTHEW SHAWN MALLARD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075833

License Status

EXPIRED

Business

Title

First Name

MATTHEW

Middle

SHAWN

Last Name

MALLARD

Business Name

MATTHEW SHAWN MALLARD MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2023

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

03/06/2024