SYLVAN MATTHEW WALLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036121971

License Status

NOT RENEWED

Business

Title

First Name

SYLVAN

Middle

MATTHEW

Last Name

WALLER

Business Name

SYLVAN MATTHEW WALLER MD

Original Issue Date

09/18/2008

Effective Date

09/18/2008

Expiration Date

07/31/2011

City

ATLANTA

State

Zip

30306

County

GEORGIA

Ever Disciplined

LastModifiedDate

03/20/2018