LAURA WALLACE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155372

License Status

ACTIVE

Business

Title

First Name

LAURA

Last Name

WALLACE

Business Name

LAURA WALLACE MD

Original Issue Date

01/21/2021

Effective Date

07/10/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63110

Ever Disciplined

LastModifiedDate

07/10/2023