LARRY R WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043057315

License Status

NOT RENEWED

Business

First Name

LARRY R

Last Name

WALLACE

Business Name

LARRY R WALLACE

Original Issue Date

05/09/1983

Expiration Date

01/31/1987

City

MOUNT VERNON

State

Zip

62864

County

JACKSON

Ever Disciplined

LastModifiedDate

10/21/2005