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| 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 for DOH Webpage: | Permanent license surrender issued pursuant to New York State Public Health Law Section 230.13. | |
| Misconduct Description for DOH Webpage: | This action is not disciplinary in nature. | |
| License Limitations or Conditions for DOH Webpage: | ||
| Board Order: |
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