PHYLLIS ANN HAGAN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209008622

License Status

NOT RENEWED

Business

First Name

PHYLLIS

Middle

ANN

Last Name

HAGAN

Business Name

PHYLLIS ANN HAGAN

Original Issue Date

01/26/2011

Effective Date

01/26/2011

Expiration Date

05/31/2012

City

KENOSHA

State

Zip

53140

County

WISCONSIN

Ever Disciplined

LastModifiedDate

07/10/2012