Indiana
Professional Licensing Agency
David Charles Wallace
Controlled Substance Registration-Osteopathic Physician
License number
02003285B
Date granted
12/05/2007
Date expires
06/30/2009
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
500 N Nappanee Street, Ste 11-B, Elkhart IN 46514
indianalicensing.org
ID 5799111
LAST UPDATED 2024-04-17 21:03:09 UTC
LAST UPDATED 2024-04-17 21:03:09 UTC
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