WALLACE M ANDERSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036082306

License Status

ACTIVE

Business

First Name

WALLACE M

Last Name

ANDERSON

Suffix

Business Name

WALLACE M ANDERSON MD

Original Issue Date

04/12/1991

Effective Date

06/23/2023

Expiration Date

07/31/2026

City

LITCHFIELD

State

Zip

62056

County

MONTGOMERY

Ever Disciplined

LastModifiedDate

06/23/2023