The holder whose full name is Mallender, Charles David,come from Salt Lake City UT,hold the Physician license(NO.01034563A) which status is Expired Non-Renewable.
| Name | Mallender, Charles David |
|---|---|
| License Number | 01034563A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Salt Lake City |
| State | UT |