TERRELL ANNETTE FORTH Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041178073

License Status

NOT RENEWED

Business

First Name

TERRELL ANNETTE

Last Name

FORTH

Business Name

TERRELL ANNETTE FORTH

Original Issue Date

10/12/1977

Effective Date

10/12/1977

Expiration Date

05/31/2004

City

CENTRALIA

State

Zip

62801

County

MARION

Ever Disciplined

LastModifiedDate

10/09/2006