KHURSHEED A MALLICK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

First Name

KHURSHEED A

Last Name

MALLICK

Suffix

Business Name

KHURSHEED A MALLICK MD

Original Issue Date

01/01/1997

Effective Date

04/11/2011

Expiration Date

07/31/2014

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014