SHARON KAY NUGENT WALLACE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

Title

First Name

SHARON

Middle

KAY NUGENT

Last Name

WALLACE

Business Name

SHARON KAY NUGENT WALLACE MD

Original Issue Date

03/04/2009

Effective Date

09/01/2020

Expiration Date

07/31/2023

City

ANNA

State

Zip

62906

County

UNION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023