PAUL S HAVRILKA III Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****66

License Status

INACTIVE

Business

First Name

PAUL

Middle

Last Name

HAVRILKA III

Business Name

PAUL S HAVRILKA III

Original Issue Date

07/21/2014

Effective Date

07/21/2014

Expiration Date

05/31/2016

City

MCLEANSBORO

State

Zip

62859

County

HAMILTON

Ever Disciplined

LastModifiedDate

07/21/2014