SUSAN MARIE BASHAM Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041176195

License Status

INACTIVE

Business

First Name

SUSAN MARIE

Last Name

BASHAM

Business Name

SUSAN MARIE BASHAM

Original Issue Date

10/12/1977

Effective Date

06/08/2022

Expiration Date

05/31/2024

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

04/09/2024