ERIC WILLIAM WALLACE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036133977

License Status

NOT RENEWED

Business

Title

First Name

ERIC

Middle

WILLIAM

Last Name

WALLACE

Business Name

ERIC WILLIAM WALLACE MD

Original Issue Date

09/18/2013

Effective Date

05/30/2014

Expiration Date

07/31/2017

City

SAN DIEGO

State

Zip

92128

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

11/01/2017