KIMBERLY D WALLACE Speech-Language Pathologist License verification

Business Entity

ACTIVE

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146006036

License Status

ACTIVE

Business

First Name

KIMBERLY

Middle

Last Name

WALLACE

Business Name

KIMBERLY D WALLACE

Original Issue Date

07/20/1999

Effective Date

08/07/2025

Expiration Date

10/31/2027

City

OFALLON

State

Zip

62269

Ever Disciplined

LastModifiedDate

08/07/2025