License holder summary

Jason Reed Wallace is a Medical - Physician licensed to practice in Colorado. The address on file for Jason Reed Wallace is 95 S. Pagosa Blvd. Suite 200, Pagosa Springs, CO, 81147-1147. This licensed professional license is current. The license was granted 12/29/2011 and expired on 04/30/2015.

Colorado

Division of Professions and Occupations

Jason Reed Wallace
Medical - Physician
License number
50788
Date granted
12/29/2011
Date expires
04/30/2015
Class
Medical - Physician
Status
Active
Address
95 S. Pagosa Blvd. Suite 200, Pagosa Springs, CO, 81147-1147
coloradolicensing.org
ID 27429083
LAST UPDATED 2024-04-30 22:37:35 UTC

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