PHILLIP DAVID MCMULLEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068421

License Status

CANCELLED

Business

Title

First Name

PHILLIP

Middle

DAVID

Last Name

MCMULLEN

Business Name

PHILLIP DAVID MCMULLEN MD

Original Issue Date

06/24/2019

Effective Date

06/24/2019

Expiration Date

06/23/2020

City

VALPARAISO

State

Zip

46385

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

03/05/2019