HOLLY ANN WALLACE Respiratory Care Practitioner License verification

Business Entity

NOT RENEWED

License Type

Respiratory Care Practitioner

Description

RESPIRATORY CARE PRACTITIONER

License Number

194008478

License Status

NOT RENEWED

Business

First Name

HOLLY

Middle

ANN

Last Name

WALLACE

Business Name

HOLLY ANN WALLACE

Original Issue Date

12/15/2010

Effective Date

10/22/2013

Expiration Date

10/31/2015

City

MONROE CITY

State

Zip

63456

County

MISSOURI

Ever Disciplined

LastModifiedDate

12/09/2015