License holder summary

Jason Robert Wallace is a Optometric Legend Drug Certificate licensed to practice in Indiana. The address on file for Jason Robert Wallace is Bloomington IN 47403. This licensed professional license is not current. The license was granted 10/10/2006 and expired on 04/01/2010.

Indiana

Professional Licensing Agency

Jason Robert Wallace
Optometric Legend Drug Certificate
License number
18003441B
Date granted
10/10/2006
Date expires
04/01/2010
Class
Optometric Legend Drug Certificate
Status
Expired
Address
Bloomington IN 47403
indianalicensing.org
ID 8284045
LAST UPDATED 2024-03-24 15:39:03 UTC

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