MELISSA KAY WALLACE Surgical Assistant/Technologist License verification

Business Entity

NOT RENEWED

License Type

Surgical Assistant/Technologist

Description

REGISTERED SURGICAL ASSISTANT

License Number

238000432

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

KAY

Last Name

WALLACE

Business Name

MELISSA KAY WALLACE

Original Issue Date

09/11/2014

Effective Date

04/05/2016

Expiration Date

04/30/2018

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

06/19/2018