MARK BURNETTE WALL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036120717

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

BURNETTE

Last Name

WALL

Business Name

MARK BURNETTE WALL MD

Original Issue Date

04/24/2008

Effective Date

07/23/2014

Expiration Date

07/31/2017

City

SANTA MONICA

State

Zip

90404

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

11/01/2017