SHIRLEY A ROTH Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041111114

License Status

INACTIVE

Business

First Name

SHIRLEY A

Last Name

ROTH

Business Name

SHIRLEY A ROTH

Original Issue Date

10/09/1964

Effective Date

10/09/1964

Expiration Date

05/31/1984

City

MACKINAW

State

Zip

61755

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/27/2006