INGOLF WALLOW MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036052570

License Status

INACTIVE

Business

First Name

INGOLF

Last Name

WALLOW

Suffix

Business Name

INGOLF WALLOW MD

Original Issue Date

03/26/1976

Effective Date

03/26/1976

Expiration Date

07/31/2005

City

MIDDLETON

State

Zip

53562

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/09/2006