FEROZAN MALAL MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****39

NOT RENEWED

N

FEROZAN

MALAL

MD

FEROZAN MALAL MD

09/15/2004

09/15/2004

07/31/2005

SPRINGFIELD

IL

62702

SANGAMON

II III IV V

N

10/09/2006