SUSAN R PROVOST Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041227206

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

Last Name

PROVOST

Business Name

SUSAN R PROVOST

Original Issue Date

11/02/1984

Effective Date

04/13/2010

Expiration Date

05/31/2012

City

FRANKFORT

State

Zip

60423

County

WILL

Ever Disciplined

LastModifiedDate

08/20/2012