GEORGE W WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043079079

License Status

NOT RENEWED

Business

First Name

GEORGE W

Last Name

WALLACE

Business Name

GEORGE W WALLACE

Original Issue Date

03/26/1996

Effective Date

03/04/2005

Expiration Date

01/31/2005

City

BRAIDWOOD

State

Zip

60408

County

WILL

Ever Disciplined

LastModifiedDate

10/15/2005