Louisiana
Board of Licensing
Wallace, Mark S.
Medical
License number
MD.019487
Date expires
09/30/2015
Class
Medical
Status
Active
Address
607 S New Ballas Rd. Ste 2300, St. Louis, MO 63141
louisianalicensing.com
ID 21974115
LAST UPDATED 2024-03-02 04:30:42 UTC
LAST UPDATED 2024-03-02 04:30:42 UTC