MALLORY COLLINS WEAVER DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125082507

License Status

CANCELLED

Business

Title

First Name

MALLORY

Middle

COLLINS

Last Name

WEAVER

Business Name

MALLORY COLLINS WEAVER DO

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2026

City

PEORIA

State

Zip

61602

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/19/2026