CAROLYN KAY WALLER Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043053497

License Status

INACTIVE

Business

First Name

CAROLYN

Middle

KAY

Last Name

WALLER

Business Name

CAROLYN KAY WALLER

Original Issue Date

01/13/1982

Effective Date

12/13/2012

Expiration Date

01/31/2015

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

11/07/2014