JUSTIN DAVID WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041473506

License Status

NOT RENEWED

Business

First Name

JUSTIN

Middle

DAVID

Last Name

WALLACE

Business Name

JUSTIN DAVID WALLACE

Original Issue Date

12/22/2018

Effective Date

12/22/2018

Expiration Date

09/30/2020

City

GAINESVILLE

State

Zip

30501

Ever Disciplined

LastModifiedDate

01/14/2021