MARK EDWARD MCMELLEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

EDWARD

Last Name

MCMELLEN

Business Name

MARK EDWARD MCMELLEN MD

Original Issue Date

10/02/2019

Effective Date

10/02/2019

Expiration Date

09/30/2020

City

SAINT LOUIS

State

Zip

63119

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021