PHYLLIS K ROTH Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209001017

License Status

INACTIVE

Business

First Name

PHYLLIS K

Last Name

ROTH

Business Name

PHYLLIS K ROTH

Original Issue Date

06/15/2001

Effective Date

06/15/2001

Expiration Date

05/31/2006

City

DANVILLE

State

Zip

61832

County

VERMILION

Ever Disciplined

LastModifiedDate

06/09/2008