STAWANNA T GOFORTH Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041082581

License Status

INACTIVE

Business

First Name

STAWANNA T

Last Name

GOFORTH

Business Name

STAWANNA T GOFORTH

Original Issue Date

12/01/1955

Effective Date

12/01/1955

Expiration Date

05/31/1988

City

LEWISTOWN

State

Zip

61542

County

FULTON

Ever Disciplined

LastModifiedDate

09/27/2006