INGRID M CLARK Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041142325

License Status

INACTIVE

Business

First Name

INGRID M

Last Name

CLARK

Business Name

INGRID M CLARK

Original Issue Date

11/23/1971

Effective Date

05/31/2012

Expiration Date

05/31/2014

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

03/06/2014