License holder summary

Douglas Charles Wallace is a Physician licensed to practice in Indiana. The address on file for Douglas Charles Wallace is Marion IL 62959-1429. This licensed professional license is current. The license was granted 11/30/2012 and expired on 10/31/2013.

Indiana

Professional Licensing Agency

Douglas Charles Wallace
Physician
License number
01071946A
Date granted
11/30/2012
Date expires
10/31/2013
Class
Physician
Status
Active
Address
Marion IL 62959-1429
indianalicensing.org
ID 6074326
LAST UPDATED 2024-02-13 11:29:18 UTC

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