VIRGINIA LIVINGSTON WALLACE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036160707

License Status

ACTIVE

Business

Title

First Name

VIRGINIA

Middle

LIVINGSTON

Last Name

WALLACE

Business Name

VIRGINIA LIVINGSTON WALLACE MD

Original Issue Date

05/27/2022

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

BROOKFIELD

State

Zip

53005

Ever Disciplined

LastModifiedDate

03/18/2024