KAITLYN MARIE WALLACE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059485

License Status

EXPIRED

Business

Title

First Name

KAITLYN

Middle

MARIE

Last Name

WALLACE

Business Name

KAITLYN MARIE WALLACE MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

09/04/2015