Physician Last Name | Mallis |
Physician First Name | Seymour |
Physician Middle Name | |
Address | 7051 Alvarado Road, Le Mesa, California 91942 |
License Number | 084819 |
License Type | MD |
Year Of Birth | 1930 |
Effective Date | 03/12/2021 |
Action Description | Permanent license surrender issued pursuant to New York State Public Health Law Section 230.13. |
Misconduct Description | This action is not disciplinary in nature. |