License holder summary

Wallace, Adam Nathan is a Medical Physician/Surgeon Temporary licensed to practice in Missouri. This licensed professional license is current. The license was granted 07/01/2011 and expired on 06/30/2014.

Missouri

Division of Professional Registration

Wallace, Adam Nathan
Medical Physician/Surgeon Temporary
License number
2011016982  
Date granted
07/01/2011
Date expires
06/30/2014
Class
Medical Physician/Surgeon Temporary
Status
Clear
licensingmissouri.org
ID 2095541
LAST UPDATED 2024-04-27 15:31:31 UTC

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