MARY E BANTA Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043008080

License Status

INACTIVE

Business

First Name

MARY E

Last Name

BANTA

Business Name

MARY E BANTA

Original Issue Date

07/22/1958

Effective Date

11/29/2004

Expiration Date

01/31/2005

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/15/2005