SUSAN ANN WALLACE
License Number: APRN3262052
Data As Of 6/24/2024
| Profession | Advanced Practice Registered Nurse | ||
|---|---|---|---|
| License | APRN3262052 | ||
| License Status | CLEAR/Active | ||
| Qualifications | Adult Nurse Practitioner | Nurse Practitioner | Autonomous Practice APRN |
| License Expiration Date | 4/30/2025 | ||
| License Original Issue Date | 01/01/1998 | ||
| Address of Record | 3939 CHEVAL BLVD | ||
| LUTZ, FL 33548 | |||
| Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain) | No | ||
| Discipline on File | No | ||
| Public Complaint | No |
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