Jacob Martin Wallace
ExpiredCalifornia license 649851
License
- Licensed by
- California Board of Registered Nursing
- License number
- 649851
- Status
- Expired (Delinquent)
- First issued
- December 20, 2004
- Expired
- November 30, 2006
- License holder
- Jacob Martin Wallace
- Entity type
- Individual
Classifications
- Registered Nurse Nursing
More from the license record
- License type code
- 4001
Contact
Hc33 Box 33572
4 Burdick Ln
Ely, NV 89301
4 Burdick Ln
Ely, NV 89301
White Pine County