TRACY A GUSTAFSON Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041306486

License Status

NOT RENEWED

Business

First Name

TRACY

Middle

Last Name

GUSTAFSON

Business Name

TRACY A GUSTAFSON

Original Issue Date

10/10/1997

Effective Date

03/20/2014

Expiration Date

05/31/2016

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

07/11/2016