MALLORIE BARRETT HENEGHAN 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

Title

First Name

MALLORIE

Middle

BARRETT

Last Name

HENEGHAN

Business Name

MALLORIE BARRETT HENEGHAN MD

Original Issue Date

05/25/2017

Effective Date

05/25/2017

Expiration Date

09/30/2020

City

PHILADELPHIA

State

Zip

19146

County

PENNSYLVANIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021