KELLY CLARK WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041272948

License Status

NOT RENEWED

Business

First Name

KELLY

Last Name

CLARK WALLACE

Business Name

KELLY CLARK WALLACE

Original Issue Date

03/22/1993

Effective Date

03/22/1993

Expiration Date

05/31/2000

City

ST LOUIS

State

Zip

63119

County

MISSOURI

Ever Disciplined

LastModifiedDate

09/27/2006