LEPORTER A IVORY MIXON Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041166012

License Status

INACTIVE

Business

First Name

LEPORTER A

Last Name

IVORY MIXON

Business Name

LEPORTER A IVORY MIXON

Original Issue Date

03/19/1976

Effective Date

03/19/1976

Expiration Date

05/31/1998

City

EAST ST LOUIS

State

Zip

62207

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

09/27/2006