PENNY FRANTOM WALLACE Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041194601

License Status

INACTIVE

Business

First Name

PENNY FRANTOM

Last Name

WALLACE

Business Name

PENNY FRANTOM WALLACE

Original Issue Date

04/24/1980

Effective Date

04/24/1980

Expiration Date

05/01/1982

City

SHREVEPORT

State

Zip

71104

County

LOUISIANA

Ever Disciplined

LastModifiedDate

09/27/2006