MATTHEW ALEXANDER WALLACE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085009017

License Status

ACTIVE

Business

First Name

MATTHEW

Middle

ALEXANDER

Last Name

WALLACE

Business Name

MATTHEW ALEXANDER WALLACE

Original Issue Date

07/09/2022

Effective Date

02/28/2026

Expiration Date

03/01/2028

City

TAMPA

State

Zip

33545

Ever Disciplined

LastModifiedDate

02/28/2026