ROBERT ERIC WALLACE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209005245

License Status

ACTIVE

Business

First Name

ROBERT

Middle

ERIC

Last Name

WALLACE

Business Name

ROBERT ERIC WALLACE

Original Issue Date

08/18/2004

Effective Date

03/13/2026

Expiration Date

05/31/2028

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

03/13/2026