GARY WAYNE WALLACE
Idaho TLM-2175 Upgraded
This Idaho license was held by GARY WAYNE WALLACE. The license is no longer active. It was granted on 05/13/1993
LICENSE DETAILS
- License Number: TLM-2175
- Category: Board Of Medicine
- Status: Upgraded
- Date Granted: 05/13/1993 (about 31 years ago)
LOCATIONS
A Residential
2295 Coronado St Idaho Falls ID 83404