SANDRA A WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043086337

License Status

NOT RENEWED

Business

First Name

SANDRA

Middle

Last Name

WALLACE

Business Name

SANDRA A WALLACE

Original Issue Date

08/01/2001

Effective Date

04/06/2005

Expiration Date

01/31/2007

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

03/16/2007