LAURA L WALLY Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

ACTIVE

Business

First Name

LAURA

Middle

Last Name

WALLY

Business Name

LAURA L WALLY

Original Issue Date

05/08/2002

Effective Date

07/19/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60610

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/19/2023