License holder summary

WALLER, LISA MARIE is a Medical - Physician Assistant licensed to practice in Georgia. The address on file for WALLER, LISA MARIE is 4254 RIVER GREEN DRIVE | APT. 608, Atlanta 30327. This doctor license is not current. The license was granted 05/06/2005 and expired on 10/31/2012.

Georgia

Composite Medical Board

WALLER, LISA MARIE
Medical - Physician Assistant
License number
004516
Date granted
05/06/2005
Date expires
10/31/2012
Class
Medical - Physician Assistant
Status
Lapsed
Address
4254 RIVER GREEN DRIVE | APT. 608
georgiadoctors.net
ID 38102312
LAST UPDATED 2024-03-19 21:03:58 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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