THEODORE W WALL Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041238858

License Status

NOT RENEWED

Business

First Name

THEODORE W

Last Name

WALL

Business Name

THEODORE W WALL

Original Issue Date

09/22/1986

Effective Date

05/29/2020

Expiration Date

08/31/2022

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

10/14/2022