LUKE STEWART WALLIS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074190

License Status

CANCELLED

Business

Title

First Name

LUKE

Middle

STEWART

Last Name

WALLIS

Business Name

LUKE STEWART WALLIS MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

05/21/2019