ROBERT E PIVONKA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****10

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

Last Name

PIVONKA

Business Name

ROBERT E PIVONKA

Original Issue Date

02/04/2004

Effective Date

04/08/2014

Expiration Date

05/31/2016

City

RIO RANCHO

State

Zip

87124

County

NEW MEXICO

Specialty/Qualifier

PRACTITIONER

Ever Disciplined

LastModifiedDate

07/11/2016