ADAM DONALD WALLACE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036145300

License Status

ACTIVE

Business

Title

First Name

ADAM

Middle

DONALD

Last Name

WALLACE

Business Name

ADAM DONALD WALLACE MD

Original Issue Date

03/14/2018

Effective Date

06/29/2023

Expiration Date

07/31/2026

City

VERONA

State

Zip

53593

Ever Disciplined

LastModifiedDate

06/29/2023