License holder summary

GARY WAYNE WALLACE is a Board Of Medicine licensed to practice in Idaho. The address on file for GARY WAYNE WALLACE is 2295 Coronado St Idaho Falls ID 83404. This licensed professional license is current. The license was granted 06/12/1993 and expired on 06/30/2018.

Idaho

Division of Occupational and Professional Licenses

GARY WAYNE WALLACE
Board Of Medicine
License number
M-6226
Date granted
06/12/1993
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
2295 Coronado St Idaho Falls ID 83404
idaholicensing.com
ID 48342985
LAST UPDATED 2024-04-13 01:24:25 UTC

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