PHILIP A WALLER MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036082202

License Status

INACTIVE

Business

First Name

PHILIP A

Last Name

WALLER

Suffix

Business Name

PHILIP A WALLER MD

Original Issue Date

03/19/1991

Effective Date

03/19/1991

Expiration Date

07/31/1993

City

LEAGUE CITY

State

Zip

77573

County

TEXAS

Ever Disciplined

LastModifiedDate

09/20/2006