Wallace Adam Goforth

License

Licensed by

Illinois Department of Financial and Professional Regulation

License number

209016165

Status

Expired (Not Renewed)

First issued

July 12, 2017

Expired

September 30, 2020

License holder

Wallace Adam Goforth

Entity type

Individual

Classifications

• Advanced Practice Registered Nurse Nursing

More from the license record

Current term began

04/26/2018

Other Illinois licenses under this name

• IL
  Wallace Adam Goforth

  License 041449328

  Registered Professional Nurse (Nursing Board)
  Expired

  Carbondale, IL

  Expired Sep 30, 2020

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