WALLACE BLAKE MCKINNEY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036147959

License Status

ACTIVE

Business

Title

First Name

WALLACE

Middle

BLAKE

Last Name

MCKINNEY

Business Name

WALLACE BLAKE MCKINNEY MD

Original Issue Date

12/21/2018

Effective Date

06/17/2023

Expiration Date

07/31/2026

City

LOOMIS

State

Zip

95650

Ever Disciplined

LastModifiedDate

06/17/2023