FADI A MALAK Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****24

License Status

NOT RENEWED

Business

First Name

FADI A

Last Name

MALAK

Business Name

FADI A MALAK

Original Issue Date

07/30/1990

Effective Date

07/30/1990

Expiration Date

01/31/1993

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006