FORUM P PATEL Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209010788

License Status

NOT RENEWED

Business

First Name

FORUM

Middle

Last Name

PATEL

Business Name

FORUM P PATEL

Original Issue Date

10/02/2013

Effective Date

03/19/2014

Expiration Date

05/31/2016

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

07/11/2016