MARIETTA FAYE KELLUM Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041157902

License Status

INACTIVE

Business

First Name

MARIETTA FAYE

Last Name

KELLUM

Business Name

MARIETTA FAYE KELLUM

Original Issue Date

12/06/1974

Effective Date

08/03/2020

Expiration Date

08/31/2022

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

08/08/2022