SUMER KAY ALLENSWORTH WALLACE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144129

License Status

ACTIVE

Business

Title

First Name

SUMER

Middle

KAY ALLENSWORTH

Last Name

WALLACE

Business Name

SUMER KAY ALLENSWORTH WALLACE MD

Original Issue Date

08/17/2017

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

04/06/2023