ADAM WALLACE Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209024161

License Status

NOT RENEWED

Business

First Name

ADAM

Last Name

WALLACE

Business Name

ADAM WALLACE

Original Issue Date

10/06/2021

Effective Date

10/06/2021

Expiration Date

08/31/2022

City

FORTSON

State

Zip

31808

Ever Disciplined

LastModifiedDate

10/14/2022