DOROTHY M WALLACE Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041097588

License Status

INACTIVE

Business

First Name

DOROTHY M

Last Name

WALLACE

Business Name

DOROTHY M WALLACE

Original Issue Date

11/10/1960

Effective Date

03/17/2010

Expiration Date

05/31/2012

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

03/08/2012