THOMAS E WALLACE MD SC Medical Corporation License verification

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042617611

License Status

NOT RENEWED

Business

Business Name

THOMAS E WALLACE MD SC

Original Issue Date

03/27/2002

Effective Date

03/27/2002

Expiration Date

01/01/2003

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/26/2006