DIANA M PETITGOUT Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041187217

License Status

INACTIVE

Business

First Name

DIANA M

Last Name

PETITGOUT

Business Name

DIANA M PETITGOUT

Original Issue Date

04/19/1979

Effective Date

04/19/1979

Expiration Date

05/31/2002

City

GALENA

State

Zip

61036

County

JO DAVIESS

Ever Disciplined

LastModifiedDate

10/09/2006