Utah
Division of Occupational and Professional Licensing
DANIELLE CHARISSE WALLACE
Physician - Physician & Surgeon
License number
8023169-1205
Date granted
09/07/2011
Date expires
01/31/2016
Class
Physician - Physician & Surgeon
Status
Active
Address
VERNAL, UT 84078
utahlicensing.org
ID 29921750
LAST UPDATED 2024-04-20 10:37:51 UTC
LAST UPDATED 2024-04-20 10:37:51 UTC
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