JAMES A WALLACE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

JAMES

Middle

Last Name

WALLACE

Suffix

Business Name

JAMES A WALLACE MD

Original Issue Date

05/19/2008

Effective Date

04/29/2014

Expiration Date

07/31/2017

City

HARVEY

State

Zip

60426

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020