L GABRIELLE ESSONINAM WALLACE DVM Veterinarian License verification

Business Entity

NOT RENEWED

License Type

Veterinarian

Description

LICENSED VETERINARIAN CONTROLLED SUBSTANCE

License Number

39*****03

License Status

NOT RENEWED

Business

Title

DVM

First Name

L GABRIELLE

Middle

ESSONINAM

Last Name

WALLACE

Business Name

L GABRIELLE ESSONINAM WALLACE DVM

Original Issue Date

11/30/2018

Effective Date

12/16/2020

Expiration Date

01/31/2023

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/31/2023