MALIK M MERCHANT Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

CANCELLED

Business

First Name

MALIK

Middle

Last Name

MERCHANT

Business Name

MALIK M MERCHANT

Original Issue Date

11/17/1995

Effective Date

11/17/1995

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006