TRACEY A PARK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041343488

License Status

NOT RENEWED

Business

First Name

TRACEY

Middle

Last Name

PARK

Business Name

TRACEY A PARK

Original Issue Date

10/29/2004

Effective Date

10/29/2004

Expiration Date

05/31/2008

City

SHERMAN

State

Zip

62684

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/11/2008