COLLINS R WALLACE MD INC

Medical Licensing Board - Medical Corporation

Indiana  50001110A   Expired

This Indiana license was held by COLLINS R WALLACE MD INC. The license is no longer active. It was granted on 09/29/1976 and expired on 12/31/1983

LICENSE DETAILS

  • License Number: 50001110A
  • Category: Medical Corporation
  • Status: Expired
  • Date Granted: 09/29/1976 (over 48 years ago)
  • Expiry Date: 12/31/1983 (over 41 years ago)

LOCATIONS

A Address

126 TIMBER LANE, FORT WAYNE IN 46825