PHENEATHIAER WALLACE - Registered Nurse License in Indiana | # 043137198

PHENEATHIAER WALLACE

Business Entity

ACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043137198

License Status

ACTIVE

Business

N

First Name

PHENEATHIAER

Last Name

WALLACE

Business Name

PHENEATHIAER WALLACE

Original Issue Date

03/11/2025

Effective Date

03/11/2025

Expiration Date

01/31/2027

State

IN

Ever Disciplined

N

LastModifiedDate

03/04/2025