WALLACE WAYNE GIST MD - Medical Doctor License in Colorado | # 036029575

WALLACE WAYNE GIST MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036029575

License Status

NOT RENEWED

Business

N

First Name

WALLACE WAYNE

Last Name

GIST

Suffix

MD

Business Name

WALLACE WAYNE GIST MD

Original Issue Date

09/15/1949

Effective Date

09/15/1949

Expiration Date

07/01/1982

State

CO

Ever Disciplined

N

LastModifiedDate

09/20/2006