M A AUDILE FORTMAN Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041117435

License Status

INACTIVE

Business

First Name

M A AUDILE

Last Name

FORTMAN

Business Name

M A AUDILE FORTMAN

Original Issue Date

05/12/1966

Effective Date

04/09/2010

Expiration Date

05/31/2012

City

CHICAGO

State

Zip

60645

County

COOK

Ever Disciplined

LastModifiedDate

03/08/2012