LINDA S WALLACE Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****13

License Status

NOT RENEWED

Business

First Name

LINDA

Middle

Last Name

WALLACE

Business Name

LINDA S WALLACE

Original Issue Date

08/17/2001

Effective Date

04/19/2012

Expiration Date

05/31/2014

City

EAST SAINT LOUIS

State

Zip

62204

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Ever Disciplined

LastModifiedDate

07/03/2014