M ELIZABETH PROVOST Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041191300

License Status

NOT RENEWED

Business

First Name

M ELIZABETH

Last Name

PROVOST

Business Name

M ELIZABETH PROVOST

Original Issue Date

10/17/1979

Effective Date

04/30/2020

Expiration Date

08/31/2022

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

10/14/2022