MILDRED D SAMPLE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043046717

License Status

NOT RENEWED

Business

First Name

MILDRED D

Last Name

SAMPLE

Business Name

MILDRED D SAMPLE

Original Issue Date

02/20/1979

City

SOUTH WOODSTOCK

State

Zip

06267

County

CONNECTICUT

Ever Disciplined

LastModifiedDate

10/21/2005