FARLA J CHAMP Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041297751

License Status

NOT RENEWED

Business

First Name

FARLA

Middle

Last Name

CHAMP

Business Name

FARLA J CHAMP

Original Issue Date

07/19/1996

Effective Date

06/05/2012

Expiration Date

05/31/2014

City

CORDOVA

State

Zip

61242

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

02/09/2015