DANIEL G WALLACE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125023530

License Status

EXPIRED

Business

First Name

DANIEL

Middle

Last Name

WALLACE

Business Name

DANIEL G WALLACE

Original Issue Date

05/04/1989

Effective Date

05/04/1989

Expiration Date

07/01/1992

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006