SHANTEL S WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043089391

License Status

NOT RENEWED

Business

First Name

SHANTEL

Middle

Last Name

WALLACE

Business Name

SHANTEL S WALLACE

Original Issue Date

12/19/2003

Effective Date

11/03/2006

Expiration Date

01/31/2009

City

ROUND LAKE

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

05/12/2009