TAMARA S WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043050637

License Status

NOT RENEWED

Business

First Name

TAMARA S

Last Name

WALLACE

Business Name

TAMARA S WALLACE

Original Issue Date

01/08/1981

Expiration Date

01/31/1985

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

10/21/2005