RAQUEL P TAGALOG Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041343351

License Status

NOT RENEWED

Business

First Name

RAQUEL

Middle

Last Name

TAGALOG

Business Name

RAQUEL P TAGALOG

Original Issue Date

10/21/2004

Effective Date

10/21/2004

Expiration Date

05/31/2006

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/09/2006