CARRIE D FORD Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041251922

License Status

NOT RENEWED

Business

First Name

CARRIE D

Last Name

FORD

Business Name

CARRIE D FORD

Original Issue Date

04/18/1989

Effective Date

08/11/2016

Expiration Date

05/31/2018

City

CHICAGO

State

Zip

60623

County

COOK

Ever Disciplined

LastModifiedDate

07/19/2018

Case Number

2017005348

Action

Suspension

Discipline Start Date

08/18/2017

Discipline End Date

09/14/2018

Discipline Reason

Failure to file and/or pay Illinois state income taxes. Notice of tax deficiency release received from Department of Revenue on 09/17/2018.