DAVID WALLACE JOHNSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036041132

License Status

NOT RENEWED

Business

First Name

DAVID WALLACE

Last Name

JOHNSON

Suffix

Business Name

DAVID WALLACE JOHNSON MD

Original Issue Date

07/07/1967

Effective Date

07/07/1967

City

MAPLEWOOD

State

Zip

55109

County

MICHIGAN

Ever Disciplined

LastModifiedDate

09/20/2006