MICHAEL M WALL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016738

License Status

EXPIRED

Business

First Name

MICHAEL M

Last Name

WALL

Suffix

Business Name

MICHAEL M WALL MD

Original Issue Date

06/01/1984

Effective Date

06/01/1984

Expiration Date

07/01/1986

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006