DIANE PHYLLIS BERGQUIST - Registered Nurse License in Wisconsin | # 041152498

DIANE PHYLLIS BERGQUIST

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041152498

License Status

INACTIVE

Business

N

First Name

DIANE PHYLLIS

Last Name

BERGQUIST

Business Name

DIANE PHYLLIS BERGQUIST

Original Issue Date

10/23/1973

Effective Date

10/23/1973

State

WI

Ever Disciplined

N

LastModifiedDate

09/27/2006