WILLIS EDWIN INGALLS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036042156

License Status

NOT RENEWED

Business

First Name

WILLIS EDWIN

Last Name

INGALLS

Suffix

Business Name

WILLIS EDWIN INGALLS MD

Original Issue Date

10/16/1968

Effective Date

10/16/1968

City

PUEBLO

State

Zip

81003

County

COLORADO

Ever Disciplined

LastModifiedDate

09/20/2006