LIZABETH J WALLACE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****49

License Status

ACTIVE

Business

First Name

LIZABETH J

Last Name

WALLACE

Business Name

LIZABETH J WALLACE

Original Issue Date

12/20/2002

Effective Date

03/06/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61603

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026