SUSAN Y ROTH Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041264676

License Status

NOT RENEWED

Business

First Name

SUSAN Y

Last Name

ROTH

Business Name

SUSAN Y ROTH

Original Issue Date

09/24/1991

Effective Date

04/10/2012

Expiration Date

05/31/2014

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/03/2014