FONDA R WALLEN Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043038983

License Status

INACTIVE

Business

First Name

FONDA R

Last Name

WALLEN

Business Name

FONDA R WALLEN

Original Issue Date

01/06/1976

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

10/21/2005