JACK S WALLACE
Medical Practice at Boulder Dr, Daytona Beach, FL

License number
Florida 532702
Issued Date
Sep 22, 2010
Effective Date
Jun 15, 2013
Expiration Date
Dec 1, 2012
Category
Health Care
Type
Emergency Medical Technician
Address
Address
932 Boulder Dr, Daytona Beach, FL 32119
Phone
(386) 589-8597
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

Professional information

Jack Wallace Photo 1

Jack Wallace - South Daytona, FL
Work:
United States Navy - Mayport, FL
Aviation Machinist Mate
Education:
Daytona State College - Daytona Beach, FL
Emergency Medical Technician Program

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