Eric David Wallisa
Controlled Substance Registration - Physician
Indiana 01054688J Active
This Indiana license is held by Eric David Wallisa. The license is currently active. It was granted on 11/26/2013 and expired on 10/31/2015
LICENSE DETAILS
- License Number: 01054688J
- Category: CSR-Physician
- Status: Active
- Date Granted: 11/26/2013 (over 10 years ago)
- Expiry Date: 10/31/2015 (over 8 years ago)
LOCATIONS
A Address
MedExpress Urgent Care, 1130 N Baldwin Avenue, Marion IN 46952-2536
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