The holder whose full name is Mallatt, Philip Russell,come from Stuart FL,hold the Dentist license(NO.12006836A) which status is Expired Non-Renewable.
| Name | Mallatt, Philip Russell |
|---|---|
| License Number | 12006836A |
| License Type | Dentist |
| License Status | Expired Non-Renewable |
| City | Stuart |
| State | FL |