LEE A PETAK Registered Nurse License verification

Business Entity

ACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041282752

License Status

ACTIVE

Business

First Name

LEE A

Last Name

PETAK

Business Name

LEE A PETAK

Original Issue Date

08/05/1994

Effective Date

03/11/2024

Expiration Date

05/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

03/01/2026