TAKARA A WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043103971

License Status

NOT RENEWED

Business

First Name

TAKARA

Middle

Last Name

WALLACE

Business Name

TAKARA A WALLACE

Original Issue Date

08/27/2007

Effective Date

01/10/2011

Expiration Date

01/31/2013

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

03/20/2013