HEATHER WALLACE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****33

License Status

ACTIVE

Business

First Name

HEATHER

Last Name

WALLACE

Business Name

HEATHER WALLACE

Original Issue Date

12/06/2024

Effective Date

02/27/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60637

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/27/2026