IDA J MORTENSEN Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041256909

License Status

INACTIVE

Business

First Name

IDA J

Last Name

MORTENSEN

Business Name

IDA J MORTENSEN

Original Issue Date

04/06/1990

Effective Date

04/16/2010

Expiration Date

05/31/2012

City

FORSYTH

State

Zip

62535

County

MACON

Ever Disciplined

LastModifiedDate

03/08/2012