DONNA MICHELE BORK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209005040

License Status

NOT RENEWED

Business

First Name

DONNA

Middle

MICHELE

Last Name

BORK

Business Name

DONNA MICHELE BORK

Original Issue Date

03/04/2004

Effective Date

03/04/2004

Expiration Date

05/31/2006

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

06/09/2008