BRENDA JEAN POLIVKA - Registered Nurse License in Indiana | # 041175604

BRENDA JEAN POLIVKA

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041175604

License Status

NOT RENEWED

Business

N

First Name

BRENDA JEAN

Last Name

POLIVKA

Business Name

BRENDA JEAN POLIVKA

Original Issue Date

10/12/1977

Effective Date

04/10/2018

Expiration Date

09/30/2020

State

IN

Ever Disciplined

N

LastModifiedDate

01/14/2021