DENISE DESIREE WALLIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036142326

License Status

NOT RENEWED

Business

First Name

DENISE

Middle

DESIREE

Last Name

WALLIS

Suffix

Business Name

DENISE DESIREE WALLIS MD

Original Issue Date

02/02/2017

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

BOSTON

State

Zip

02109

County

MASSACHUSETTS

Ever Disciplined

LastModifiedDate

01/14/2021