PHYLLIS A KIPP Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041114891

License Status

INACTIVE

Business

First Name

PHYLLIS A

Last Name

KIPP

Business Name

PHYLLIS A KIPP

Original Issue Date

10/04/1965

Effective Date

05/10/2010

Expiration Date

05/31/2012

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

03/08/2012