License holder summary

WALLACE C CARRILLO-MEDINA is a Dentist licensed to practice in Pennsylvania. The address on file for WALLACE C CARRILLO-MEDINA is Rensselaer NY 12144. This medical practitioner license is not current. The license was granted 09/16/2011 and expired on 03/31/2013.

Department of State

Board of Medicine

WALLACE C CARRILLO-MEDINA
Dentist
License number
DS038907
Date granted
09/16/2011
Date expires
03/31/2013
Class
Dentist
Status
Inactive
Address
Rensselaer NY 12144
medicinepa.com
ID 37427167
LAST UPDATED 2026-04-23 18:47:26 UTC

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