MARK R FORTMAN - Registered Nurse License in Wisconsin | # 041276097

MARK R FORTMAN

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041276097

License Status

NOT RENEWED

Business

N

First Name

MARK R

Last Name

FORTMAN

Business Name

MARK R FORTMAN

Original Issue Date

10/12/1993

Effective Date

10/12/1993

Expiration Date

05/31/1996

State

WI

Ever Disciplined

N

LastModifiedDate

09/27/2006