PHYLLIS K ROTH Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041119082

License Status

NOT RENEWED

Business

First Name

PHYLLIS K

Last Name

ROTH

Business Name

PHYLLIS K ROTH

Original Issue Date

10/06/1966

Effective Date

06/15/2020

Expiration Date

08/31/2022

City

DANVILLE

State

Zip

61832

County

VERMILION

Ever Disciplined

LastModifiedDate

10/14/2022