License Directory

Lisa Wallace D.O.

Active

Illinois license 036177164

License

Licensed by
Illinois Department of Financial and Professional Regulation
License number
036177164
Status
Active
First issued
September 15, 2025
Expires
July 31, 2029
License holder
Lisa Wallace
Entity type
Individual

Classifications

More from the license record

Current term began
07/29/2026

Contact

Grand Rapids, MI 49507