SARAH ADE WALLACE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****56

License Status

ACTIVE

Business

Title

DMD

First Name

SARAH

Middle

ADE

Last Name

WALLACE

Business Name

SARAH ADE WALLACE DMD

Original Issue Date

06/15/2010

Effective Date

09/27/2024

Expiration Date

09/30/2027

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/27/2024