PATRICIA WALLACE CONLY MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036089911

License Status

INACTIVE

Business

First Name

PATRICIA WALLACE

Last Name

CONLY

Suffix

Business Name

PATRICIA WALLACE CONLY MD

Original Issue Date

11/02/1994

Effective Date

11/02/1994

Expiration Date

07/31/1996

City

JERSEYVILLE

State

Zip

62052

County

JERSEY

Ever Disciplined

LastModifiedDate

09/20/2006