PHYLLIS JEAN FREDERICKSEN Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041353201

License Status

NOT RENEWED

Business

First Name

PHYLLIS

Middle

JEAN

Last Name

FREDERICKSEN

Business Name

PHYLLIS JEAN FREDERICKSEN

Original Issue Date

07/05/2006

Effective Date

03/11/2008

Expiration Date

05/31/2010

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

08/16/2010