JORGE MICHAEL BASCONCILLO AGCAOILI IV Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041368234

License Status

NOT RENEWED

Business

First Name

JORGE

Middle

MICHAEL

Last Name

BASCONCILLO AGCAOILI

Suffix

Business Name

JORGE MICHAEL BASCONCILLO AGCAOILI IV

Original Issue Date

06/19/2008

Effective Date

05/28/2010

Expiration Date

05/31/2012

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/10/2012