RYAN DAVID MALLORY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

ACTIVE

Business

Title

First Name

RYAN

Middle

DAVID

Last Name

MALLORY

Business Name

RYAN DAVID MALLORY MD

Original Issue Date

10/08/2023

Effective Date

10/08/2023

Expiration Date

07/31/2026

City

INDIANAPOLIS

State

Zip

46202

County

MARION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/08/2023