ETHEL M ROTH Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041190636

License Status

NOT RENEWED

Business

First Name

ETHEL

Middle

Last Name

ROTH

Business Name

ETHEL M ROTH

Original Issue Date

10/17/1979

Effective Date

03/24/2010

Expiration Date

05/31/2012

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

07/10/2012