License holder summary

COLLINS R WALLACE MD INC is a Medical Licensing Board - Medical Corporation licensed to practice in Indiana. The address on file for COLLINS R WALLACE MD INC is 126 TIMBER LANE, FORT WAYNE IN 46825. This licensed professional license is not current. The license was granted 09/29/1976 and expired on 12/31/1983.

Indiana

Professional Licensing Agency

COLLINS R WALLACE MD INC
Medical Licensing Board - Medical Corporation
License number
50001110A
Date granted
09/29/1976
Date expires
12/31/1983
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
126 TIMBER LANE, FORT WAYNE IN 46825
indianalicensing.org
ID 24826513
LAST UPDATED 2024-04-02 11:10:32 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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