STEPHANIE L WALLIS Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041332879

License Status

INACTIVE

Business

First Name

STEPHANIE

Middle

Last Name

WALLIS

Business Name

STEPHANIE L WALLIS

Original Issue Date

10/15/2002

Effective Date

05/04/2010

Expiration Date

05/31/2012

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

03/08/2012