PHYLLIS M WAGNER Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041196361

License Status

INACTIVE

Business

First Name

PHYLLIS M

Last Name

WAGNER

Business Name

PHYLLIS M WAGNER

Original Issue Date

08/06/1980

Effective Date

03/19/2012

Expiration Date

05/31/2014

City

QUINCY

State

Zip

62301

County

ADAMS

Ever Disciplined

LastModifiedDate

03/06/2014