PETER J WALLER DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036150318

License Status

ACTIVE

Business

First Name

PETER

Middle

Last Name

WALLER

Suffix

Business Name

PETER J WALLER DO

Original Issue Date

07/24/2019

Effective Date

06/30/2023

Expiration Date

07/31/2026

City

ELMHURST

State

Zip

60126

County

DUPAGE

Ever Disciplined

LastModifiedDate

06/30/2023