JOSEPH B MALLORY Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

ACTIVE

Business

First Name

JOSEPH B

Last Name

MALLORY

Business Name

JOSEPH B MALLORY

Original Issue Date

01/25/2001

Effective Date

06/15/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/15/2023