WALLACE F STROW MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

CANCELLED

Business

First Name

WALLACE F

Last Name

STROW

Suffix

Business Name

WALLACE F STROW MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2002

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006