SALLY A ROTH Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041217830

License Status

INACTIVE

Business

First Name

SALLY A

Last Name

ROTH

Business Name

SALLY A ROTH

Original Issue Date

11/08/1983

Effective Date

05/02/2012

Expiration Date

05/31/2014

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

03/06/2014