Brian David Wallace
Physician
Indiana 01055786A Inactive
This Indiana license was held by Brian David Wallace. The license is no longer active. It was granted on 02/28/2002 and expired on 10/31/2015
LICENSE DETAILS
- License Number: 01055786A
- Category: Physician
- Status: Inactive
- Date Granted: 02/28/2002 (about 23 years ago)
- Expiry Date: 10/31/2015 (over 9 years ago)
LOCATIONS
A Address
Bowling Green KY 42103