MANUEL WALLACE IV - Registered Nurse License in Illinois | # 043120060

MANUEL WALLACE IV

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043120060

License Status

NOT RENEWED

Business

N

First Name

MANUEL

Last Name

WALLACE IV

Business Name

MANUEL WALLACE IV

Original Issue Date

12/05/2014

Effective Date

01/11/2017

Expiration Date

01/31/2019

State

IL

Ever Disciplined

N

LastModifiedDate

03/28/2019