CONSTANCE M SAMPLE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041222817

License Status

NOT RENEWED

Business

First Name

CONSTANCE M

Last Name

SAMPLE

Business Name

CONSTANCE M SAMPLE

Original Issue Date

05/25/1984

Effective Date

05/25/1984

Expiration Date

05/31/1986

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/27/2006