Pheneathiaer Wallace
ActiveIllinois license 043137198
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 043137198
- Status
- Active
- First issued
- March 11, 2025
- Expires
- January 31, 2027
- License holder
- Pheneathiaer Wallace
- Entity type
- Individual
Classifications
- Licensed Practical Nurse (Nursing Board) Nursing
More from the license record
- Current term began
- 03/11/2025
Contact
Gary, IN 46407