SUSAN M BONCZYK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041389351

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

Last Name

BONCZYK

Business Name

SUSAN M BONCZYK

Original Issue Date

11/30/2010

Effective Date

11/30/2010

Expiration Date

05/31/2012

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

07/10/2012