JAMI M WALLACE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****56

License Status

ACTIVE

Business

First Name

JAMI

Middle

Last Name

WALLACE

Business Name

JAMI M WALLACE

Original Issue Date

07/31/2015

Effective Date

05/30/2024

Expiration Date

05/31/2026

City

PEKIN

State

Zip

61554

County

TAZEWELL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026