STACY M BASTEN Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041377158

License Status

INACTIVE

Business

First Name

STACY

Middle

Last Name

BASTEN

Business Name

STACY M BASTEN

Original Issue Date

07/14/2009

Effective Date

05/07/2012

Expiration Date

05/31/2014

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

03/06/2014