JOHN K WALLACE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036066729

License Status

INACTIVE

Business

First Name

JOHN K

Last Name

WALLACE

Suffix

Business Name

JOHN K WALLACE MD

Original Issue Date

06/21/1983

Effective Date

06/21/1983

Expiration Date

07/31/1987

City

DOTHAN

State

Zip

36301

County

ALABAMA

Ever Disciplined

LastModifiedDate

09/20/2006