R PHYLLIS M WAGNER Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041146763

License Status

NOT RENEWED

Business

First Name

R PHYLLIS M

Last Name

WAGNER

Business Name

R PHYLLIS M WAGNER

Original Issue Date

12/13/1972

Effective Date

12/13/1972

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

09/27/2006