DAVID B WALLACE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036050183

License Status

NOT RENEWED

Business

First Name

DAVID B

Last Name

WALLACE

Suffix

Business Name

DAVID B WALLACE MD

Original Issue Date

10/10/1974

Effective Date

09/01/2020

Expiration Date

07/31/2023

City

AURORA

State

Zip

60502

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/30/2023