MARY BETH WALLACE Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043030858

License Status

INACTIVE

Business

First Name

MARY BETH

Last Name

WALLACE

Business Name

MARY BETH WALLACE

Original Issue Date

08/01/1972

Expiration Date

01/31/1987

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/21/2005