PATRICK J WALLACE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125023752

License Status

EXPIRED

Business

First Name

PATRICK J

Last Name

WALLACE

Suffix

Business Name

PATRICK J WALLACE MD

Original Issue Date

05/11/1989

Effective Date

05/11/1989

Expiration Date

06/30/1994

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006