HEATHER E PROVO Registered Nurse License verification

Business Entity

ACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041580199

License Status

ACTIVE

Business

First Name

HEATHER

Middle

Last Name

PROVO

Business Name

HEATHER E PROVO

Original Issue Date

01/23/2025

Effective Date

01/23/2025

Expiration Date

05/31/2026

City

DIXON

State

Zip

61021

County

LEE

Ever Disciplined

LastModifiedDate

02/28/2026