HATTIE M WALLACE - Registered Nurse License in Illinois | # 043052143

HATTIE M WALLACE

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043052143

License Status

INACTIVE

Business

N

First Name

HATTIE

Middle

M

Last Name

WALLACE

Business Name

HATTIE M WALLACE

Original Issue Date

06/05/1981

Effective Date

01/31/2005

Expiration Date

01/31/2005

State

IL

Ever Disciplined

N

LastModifiedDate

10/15/2005