SUSAN DIANE FORNEY Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041165365

License Status

NOT RENEWED

Business

First Name

SUSAN DIANE

Last Name

FORNEY

Business Name

SUSAN DIANE FORNEY

Original Issue Date

01/06/1976

Effective Date

01/06/1976

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/27/2006