STACEY R WAGNER Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041378228

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

Last Name

WAGNER

Business Name

STACEY R WAGNER

Original Issue Date

08/04/2009

Effective Date

03/12/2010

Expiration Date

05/31/2012

City

CRESTWOOD

State

Zip

60445

County

COOK

Ever Disciplined

LastModifiedDate

07/10/2012