NATHAN MARSHALL STATUM IDPR Registered License verification

Business Entity

NOT RENEWED

License Type

IDPR Registered

Description

CERTIFIED EUTHANASIA TECHNICIAN

License Number

235000404

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

MARSHALL

Last Name

STATUM

Business Name

NATHAN MARSHALL STATUM

Original Issue Date

04/20/2015

Effective Date

04/20/2015

Expiration Date

04/30/2016

City

MACHESNEY PARK

State

Zip

61115

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

06/10/2016