Wisconsin
Department of Safety and Professional Services
Wallace, Virginia L
Medicine And Surgery
License number
41111-20
Date granted
06/04/1999
Date expires
10/31/2015
Class
Medicine And Surgery
Status
Active
wisconsinmedicine.org
ID 12787521
LAST UPDATED 2026-05-29 22:29:34 UTC
LAST UPDATED 2026-05-29 22:29:34 UTC
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