GEORGE WALLACE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036026275

License Status

INACTIVE

Business

First Name

GEORGE

Last Name

WALLACE

Suffix

Business Name

GEORGE WALLACE MD

Original Issue Date

03/01/1945

Effective Date

03/01/1945

Expiration Date

07/31/1987

City

PHOENIX

State

Zip

85016

County

ARIZONA

Ever Disciplined

LastModifiedDate

09/20/2006