PHYLLIS T HEAFNER Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041107602

License Status

NOT RENEWED

Business

First Name

PHYLLIS T

Last Name

HEAFNER

Business Name

PHYLLIS T HEAFNER

Original Issue Date

11/13/1963

Effective Date

11/13/1963

Expiration Date

05/31/1996

City

BELLEVILLE

State

Zip

62223

County

MADISON

Ever Disciplined

LastModifiedDate

09/27/2006