LARRY O WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041276560

License Status

NOT RENEWED

Business

First Name

LARRY O

Last Name

WALLACE

Business Name

LARRY O WALLACE

Original Issue Date

10/13/1993

Effective Date

10/13/1993

Expiration Date

05/31/1996

City

DEKALB

State

Zip

60115

County

DEKALB

Ever Disciplined

LastModifiedDate

09/27/2006