THOMAS EVERETT WALLACE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036055175

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

EVERETT

Last Name

WALLACE

Suffix

Business Name

THOMAS EVERETT WALLACE MD

Original Issue Date

07/18/1977

Effective Date

10/01/2020

Expiration Date

07/31/2023

City

LEXINGTON

State

Zip

40515

County

KENTUCKY

Ever Disciplined

LastModifiedDate

11/30/2023