TRAVIS W BROUILLETTE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041432913

License Status

NOT RENEWED

Business

First Name

TRAVIS

Middle

Last Name

BROUILLETTE

Business Name

TRAVIS W BROUILLETTE

Original Issue Date

07/24/2015

Effective Date

04/06/2020

Expiration Date

08/31/2022

City

MAKANDA

State

Zip

62958

County

JACKSON

Ever Disciplined

LastModifiedDate

10/14/2022