LARRY R WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041235052

License Status

NOT RENEWED

Business

First Name

LARRY R

Last Name

WALLACE

Business Name

LARRY R WALLACE

Original Issue Date

04/18/1986

Effective Date

04/18/1986

Expiration Date

05/31/2004

City

FLORISSANT

State

Zip

63031

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/09/2006