GAMALIA WALLACE Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043021321

License Status

INACTIVE

Business

First Name

GAMALIA

Last Name

WALLACE

Business Name

GAMALIA WALLACE

Original Issue Date

12/07/1967

Effective Date

12/08/2004

Expiration Date

01/31/2005

City

CHICAGO

State

Zip

60643

County

COOK

Ever Disciplined

LastModifiedDate

10/15/2005