WALLIS OLIVIA EDWARDS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

ACTIVE

Business

Title

First Name

WALLIS

Middle

OLIVIA

Last Name

EDWARDS

Business Name

WALLIS OLIVIA EDWARDS MD

Original Issue Date

04/05/2023

Effective Date

04/05/2023

Expiration Date

07/31/2026

City

ZION

State

Zip

60099

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2023