PHYLLIS A FORD Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041076996

License Status

INACTIVE

Business

First Name

PHYLLIS A

Last Name

FORD

Business Name

PHYLLIS A FORD

Original Issue Date

12/17/1953

Effective Date

12/17/1953

Expiration Date

05/31/2002

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

10/09/2006