JOHN EDWARD MALLON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

EDWARD

Last Name

MALLON

Suffix

Business Name

JOHN EDWARD MALLON MD

Original Issue Date

04/03/2009

Effective Date

05/15/2014

Expiration Date

07/31/2017

City

MOUNT CARMEL

State

Zip

62863

County

WABASH

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017