License holder summary

Nichole Green Wallace is a Medical - Physician licensed to practice in Colorado. The address on file for Nichole Green Wallace is 13386 Cedarville Way, Colorado Springs, CO, 80921-7642. This licensed professional license is current. The license was granted 07/15/2014 and expired on 04/30/2015.

Colorado

Division of Professions and Occupations

Nichole Green Wallace
Medical - Physician
License number
54149
Date granted
07/15/2014
Date expires
04/30/2015
Class
Medical - Physician
Status
Active
Address
13386 Cedarville Way, Colorado Springs, CO, 80921-7642
coloradolicensing.org
ID 27429086
LAST UPDATED 2024-04-08 12:05:31 UTC

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