BREANNA B WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043127628

License Status

NOT RENEWED

Business

First Name

BREANNA

Middle

Last Name

WALLACE

Business Name

BREANNA B WALLACE

Original Issue Date

08/19/2019

Effective Date

01/20/2021

Expiration Date

01/31/2023

City

SPRINGFIELD

State

Zip

62702

Ever Disciplined

LastModifiedDate

03/31/2023