ANANTHA K MALLIA DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129191

License Status

INACTIVE

Business

Title

First Name

ANANTHA

Middle

Last Name

MALLIA

Business Name

ANANTHA K MALLIA DO

Original Issue Date

11/04/2011

Effective Date

11/04/2011

Expiration Date

07/31/2014

City

GREAT FALLS

State

Zip

22066

Ever Disciplined

LastModifiedDate

04/23/2024