MANJULA RAY MALLICK, MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

First Name

MANJULA RAY

Last Name

MALLICK,

Suffix

Business Name

MANJULA RAY MALLICK, MD

Original Issue Date

01/01/1997

Effective Date

06/22/2011

Expiration Date

07/31/2014

City

ORLAND PARK

State

Zip

60462

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014