PHENEATHIAER WALLACE Registered Nurse License verification

Business Entity

ACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043137198

License Status

ACTIVE

Business

First Name

PHENEATHIAER

Last Name

WALLACE

Business Name

PHENEATHIAER WALLACE

Original Issue Date

03/11/2025

Effective Date

03/11/2025

Expiration Date

01/31/2027

City

GARY

State

Zip

46407

Ever Disciplined

LastModifiedDate

03/04/2025