MARK EDWARD MCMELLEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036150905

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

EDWARD

Last Name

MCMELLEN

Business Name

MARK EDWARD MCMELLEN MD

Original Issue Date

09/30/2019

Effective Date

09/30/2019

Expiration Date

09/30/2020

City

SAINT LOUIS

State

Zip

63119

Ever Disciplined

LastModifiedDate

01/14/2021