LILLY E HAVERSTOCK Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041269640

License Status

INACTIVE

Business

First Name

LILLY E

Last Name

HAVERSTOCK

Business Name

LILLY E HAVERSTOCK

Original Issue Date

09/25/1992

Effective Date

05/13/2018

Expiration Date

09/30/2020

City

ALLENVILLE

State

Zip

61951

County

MOULTRIE

Ever Disciplined

LastModifiedDate

03/08/2020