SUSAN DIANNE GRE WAGGONER Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041157146

License Status

NOT RENEWED

Business

First Name

SUSAN DIANNE GRE

Last Name

WAGGONER

Business Name

SUSAN DIANNE GRE WAGGONER

Original Issue Date

09/11/1974

Effective Date

03/26/2014

Expiration Date

05/31/2016

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

07/11/2016