GERTRUDE A WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043010338

License Status

NOT RENEWED

Business

First Name

GERTRUDE A

Last Name

WALLACE

Business Name

GERTRUDE A WALLACE

Original Issue Date

04/02/1962

Effective Date

03/04/2003

Expiration Date

01/31/2003

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Ever Disciplined

LastModifiedDate

10/15/2005