DANE C WALLACE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209025563

License Status

ACTIVE

Business

First Name

DANE

Middle

Last Name

WALLACE

Business Name

DANE C WALLACE

Original Issue Date

07/23/2022

Effective Date

04/05/2024

Expiration Date

05/31/2026

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

03/02/2026