DEANNA L WALLACE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****74

License Status

ACTIVE

Business

First Name

DEANNA L

Last Name

WALLACE

Business Name

DEANNA L WALLACE

Original Issue Date

06/16/2016

Effective Date

03/04/2026

Expiration Date

05/31/2028

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

03/04/2026