VIVEKANANDA M WALL MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069493

License Status

INACTIVE

Business

First Name

VIVEKANANDA M

Last Name

WALL

Suffix

Business Name

VIVEKANANDA M WALL MD

Original Issue Date

09/18/1984

Effective Date

09/18/1984

Expiration Date

07/31/1987

City

WEST DES MOINES

State

Zip

50265

County

IOWA

Ever Disciplined

LastModifiedDate

05/21/2007