Louisiana
Board of Licensing
Wallace Larryetta Wilson
Medical
License number
LRT.000636
Date expires
09/30/2015
Class
Medical
Status
Active
Address
5130 Mancuso Lane, Baton Rouge, LA 70809
louisianalicensing.com
ID 21873401
LAST UPDATED 2024-02-18 19:04:16 UTC
LAST UPDATED 2024-02-18 19:04:16 UTC