SHANTEL S WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041360011

License Status

NOT RENEWED

Business

First Name

SHANTEL

Middle

Last Name

WALLACE

Business Name

SHANTEL S WALLACE

Original Issue Date

05/11/2007

Effective Date

05/08/2014

Expiration Date

05/31/2016

City

ROUND LAKE

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

07/11/2016