Glenn Philip Wallis
Medical - Physician
Colorado 21105 Revoked
This Colorado license was held by Glenn Philip Wallis. The license is no longer active. It was granted on 07/12/1977 and expired on 07/06/2005
LICENSE DETAILS
- License Number: 21105
- Category: Physician
- Status: Revoked
- Date Granted: 07/12/1977 (almost 47 years ago)
- Expiry Date: 07/06/2005 (almost 19 years ago)
LOCATIONS
A Address
575 UNION BLVD #210, LAKEWOOD, CO, 80228-0228