PATRICK LAWRENCE MALLORY DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036103345

License Status

INACTIVE

Business

First Name

PATRICK

Middle

LAWRENCE

Last Name

MALLORY

Suffix

Business Name

PATRICK LAWRENCE MALLORY DO

Original Issue Date

08/25/2000

Effective Date

08/25/2000

Expiration Date

07/31/2002

City

CHEYENNE

State

Zip

82001

County

WYOMING

Ever Disciplined

LastModifiedDate

10/09/2006