REBECCA O BANTA Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041179716

License Status

NOT RENEWED

Business

First Name

REBECCA O

Last Name

BANTA

Business Name

REBECCA O BANTA

Original Issue Date

04/03/1978

Effective Date

03/16/2010

Expiration Date

05/31/2012

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/10/2012