MICHAEL DANE WALLISCH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036095760

License Status

NOT RENEWED

Business

First Name

MICHAEL DANE

Last Name

WALLISCH

Suffix

Business Name

MICHAEL DANE WALLISCH MD

Original Issue Date

06/25/1997

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CARLISLE

State

Zip

17013

County

PENNSYLVANIA

Ever Disciplined

LastModifiedDate

11/06/2008