MARY BETH WALLACE Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041230718

License Status

INACTIVE

Business

First Name

MARY BETH

Last Name

WALLACE

Business Name

MARY BETH WALLACE

Original Issue Date

10/22/1985

Effective Date

04/18/2016

Expiration Date

05/31/2018

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

03/06/2018