URMUNDAL, MALLIK BASAVANNA, MD
Medical - Physician
Georgia 048094 Surrendered
This Georgia license was held by URMUNDAL, MALLIK BASAVANNA, MD. The license is no longer active. It was granted on 10/08/1999 and expired on 09/30/2011
LICENSE DETAILS
- License Number: 048094
- Category: Physician
- Status: Surrendered
- Date Granted: 10/08/1999 (over 24 years ago)
- Expiry Date: 09/30/2011 (over 12 years ago)
LOCATIONS
A Address
4415 US HWY 331 S STE A, DEFUNIAK SPRIN 32435