LAUREN ASHLEY WALLACE MD - Medical Doctor License in Washington | # 33*****29

LAUREN ASHLEY WALLACE MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

N

Title

MD

First Name

LAUREN

Middle

ASHLEY

Last Name

WALLACE

Business Name

LAUREN ASHLEY WALLACE MD

Original Issue Date

12/02/2016

Effective Date

09/22/2020

Expiration Date

07/31/2023

State

WA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

11/30/2023