SHANNON K FORTH Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041355421

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

Last Name

FORTH

Business Name

SHANNON K FORTH

Original Issue Date

08/28/2006

Effective Date

03/11/2008

Expiration Date

05/31/2010

City

JOHNSONVILLE

State

Zip

62850

County

WAYNE

Ever Disciplined

LastModifiedDate

08/16/2010