IDA M WALLACE
Nursing at Goodway Dr, Brooksville, FL

License number
Florida 1160861
Issued Date
Aug 12, 1994
Effective Date
Aug 19, 2009
Expiration Date
Jul 31, 2007
Category
Health Care
Type
Licensed Practical Nurse
Address
Address
6374 Goodway Dr, Brooksville, FL 34602
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

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