GWENDOLYN ELAINE BACILLA Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041335409

License Status

INACTIVE

Business

First Name

GWENDOLYN

Middle

ELAINE

Last Name

BACILLA

Business Name

GWENDOLYN ELAINE BACILLA

Original Issue Date

06/24/2003

Effective Date

06/24/2003

Expiration Date

05/31/2008

City

LAKESIDE

State

Zip

85929

County

ARIZONA

Ever Disciplined

LastModifiedDate

03/11/2008