RUSSELL KEITH WIDENER Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041317464

License Status

NOT RENEWED

Business

First Name

RUSSELL

Middle

KEITH

Last Name

WIDENER

Business Name

RUSSELL KEITH WIDENER

Original Issue Date

11/12/1999

Effective Date

03/11/2008

Expiration Date

05/31/2010

City

FULTON

State

Zip

61252

County

WHITESIDE

Ever Disciplined

LastModifiedDate

08/16/2010