STEPHEN JOSEPH WALLACE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065323

License Status

EXPIRED

Business

Title

First Name

STEPHEN

Middle

JOSEPH

Last Name

WALLACE

Business Name

STEPHEN JOSEPH WALLACE MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2019

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

10/02/2019