THOMAS MERLE WALLER DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036153369

License Status

ACTIVE

Business

Title

First Name

THOMAS

Middle

MERLE

Last Name

WALLER

Business Name

THOMAS MERLE WALLER DO

Original Issue Date

06/15/2020

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

NILES

State

Zip

60714

Ever Disciplined

LastModifiedDate

04/06/2023