MARAM MALLISHO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

ACTIVE

Business

Title

First Name

MARAM

Last Name

MALLISHO

Business Name

MARAM MALLISHO MD

Original Issue Date

12/02/2021

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

OAK LAWN

State

Zip

60453

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023