ROBERT S MALCOLM JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

First Name

ROBERT S

Last Name

MALCOLM JR

Suffix

Business Name

ROBERT S MALCOLM JR MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2002

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006