FORUM P PATEL Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****08

License Status

INOPERATIVE

Business

First Name

FORUM

Middle

Last Name

PATEL

Business Name

FORUM P PATEL

Original Issue Date

02/14/2014

Effective Date

03/19/2014

Expiration Date

05/31/2016

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

03/18/2014