JEROME N WALLACE - Registered Nurse License in Missouri | # 043068776

JEROME N WALLACE

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043068776

License Status

NOT RENEWED

Business

N

First Name

JEROME N

Last Name

WALLACE

Business Name

JEROME N WALLACE

Original Issue Date

08/07/1990

Expiration Date

01/31/1993

State

MO

Ever Disciplined

N

LastModifiedDate

10/21/2005