VIVIAN WALLACE Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043032627

License Status

INACTIVE

Business

First Name

VIVIAN

Last Name

WALLACE

Business Name

VIVIAN WALLACE

Original Issue Date

02/14/1973

City

E ST LOUIS

State

Zip

62204

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/21/2005