CAROL J WAGNER Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041107514

License Status

INACTIVE

Business

First Name

CAROL J

Last Name

WAGNER

Business Name

CAROL J WAGNER

Original Issue Date

11/13/1963

Effective Date

03/15/2010

Expiration Date

05/31/2012

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

03/08/2012