DAN RALPH PROVIDO MEDIANA - Registered Nurse License in Tennessee | # 041511860

DAN RALPH PROVIDO MEDIANA

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041511860

License Status

NOT RENEWED

Business

N

First Name

DAN RALPH

Middle

PROVIDO

Last Name

MEDIANA

Business Name

DAN RALPH PROVIDO MEDIANA

Original Issue Date

07/14/2021

Effective Date

05/19/2022

Expiration Date

06/30/2024

State

TN

Ever Disciplined

N

LastModifiedDate

02/05/2025