ELIZABETH NICOLE WALLIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

ACTIVE

Business

Title

First Name

ELIZABETH

Middle

NICOLE

Last Name

WALLIS

Business Name

ELIZABETH NICOLE WALLIS MD

Original Issue Date

09/24/2025

Effective Date

09/24/2025

Expiration Date

07/31/2026

City

PRAIRIEVILLE

State

Zip

70769

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/24/2025