The holder whose full name is Malott, Thomas Mark,come from Walton IN,hold the Physician Assistant - Prescriptive Authority license(NO.10000716A) which status is Active.
| Name | Malott, Thomas Mark |
|---|---|
| License Number | 10000716A |
| License Type | Physician Assistant - Prescriptive Authority |
| License Status | Active |
| City | Walton |
| State | IN |