TAKARA A WALLACE - Registered Nurse License in Illinois | # 043103971

TAKARA A WALLACE

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043103971

License Status

NOT RENEWED

Business

N

First Name

TAKARA

Middle

A

Last Name

WALLACE

Business Name

TAKARA A WALLACE

Original Issue Date

08/27/2007

Effective Date

01/10/2011

Expiration Date

01/31/2013

State

IL

Ever Disciplined

N

LastModifiedDate

03/20/2013