MARY L GRANTHAM Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041111540

License Status

INACTIVE

Business

First Name

MARY L

Last Name

GRANTHAM

Business Name

MARY L GRANTHAM

Original Issue Date

11/25/1964

Effective Date

03/15/2010

Expiration Date

05/31/2012

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

03/08/2012