License holder summary

WALLACE, TERRELL RICHARD is a Medical - Physician Assistant licensed to practice in Georgia. The address on file for WALLACE, TERRELL RICHARD is 136 HOUSTON LAKE ROAD, Warner Robins 31088. This doctor license is current. The license was granted 06/08/1995 and expired on 07/31/2016.

Georgia

Composite Medical Board

WALLACE, TERRELL RICHARD
Medical - Physician Assistant
License number
002665
Date granted
06/08/1995
Date expires
07/31/2016
Class
Medical - Physician Assistant
Status
Active
Address
136 HOUSTON LAKE ROAD
georgiadoctors.net
ID 38102308
LAST UPDATED 2024-02-19 18:38:27 UTC

This website is unaffiliated with the Composite Medical Board. Please verify all information directly with the relevant official government authority.

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