SHANTEL S WALLACE - Registered Nurse License in Illinois | # 043089391

SHANTEL S WALLACE

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043089391

License Status

NOT RENEWED

Business

N

First Name

SHANTEL

Middle

S

Last Name

WALLACE

Business Name

SHANTEL S WALLACE

Original Issue Date

12/19/2003

Effective Date

11/03/2006

Expiration Date

01/31/2009

State

IL

Ever Disciplined

N

LastModifiedDate

05/12/2009