HATTIE M WALLACE Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043052143

License Status

INACTIVE

Business

First Name

HATTIE

Middle

Last Name

WALLACE

Business Name

HATTIE M WALLACE

Original Issue Date

06/05/1981

Effective Date

01/31/2005

Expiration Date

01/31/2005

City

CHICAGO

State

Zip

60628

County

COOK

Ever Disciplined

LastModifiedDate

10/15/2005