JEROME N WALLACE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043068776

License Status

NOT RENEWED

Business

First Name

JEROME N

Last Name

WALLACE

Business Name

JEROME N WALLACE

Original Issue Date

08/07/1990

Expiration Date

01/31/1993

City

ST LOUIS

State

Zip

63137

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/21/2005