DAINA M MALLARD Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****21

License Status

ACTIVE

Business

First Name

DAINA

Middle

Last Name

MALLARD

Business Name

DAINA M MALLARD

Original Issue Date

07/16/2015

Effective Date

02/03/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60612

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/03/2026