SHANNON D WALLE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****10

License Status

ACTIVE

Business

First Name

SHANNON

Middle

Last Name

WALLE

Business Name

SHANNON D WALLE

Original Issue Date

09/03/2020

Effective Date

04/01/2024

Expiration Date

05/31/2026

City

SHERMAN

State

Zip

62684

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026