SANFORD RICHARD MALLIN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036036939

License Status

INACTIVE

Business

First Name

SANFORD RICHARD

Last Name

MALLIN

Suffix

Business Name

SANFORD RICHARD MALLIN MD

Original Issue Date

10/24/1960

Effective Date

10/24/1960

Expiration Date

07/31/1987

City

MILWAUKEE

State

Zip

53202

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006