PHYLLIS J HEITZ Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043010408

License Status

NOT RENEWED

Business

First Name

PHYLLIS J

Last Name

HEITZ

Business Name

PHYLLIS J HEITZ

Original Issue Date

04/02/1962

Effective Date

03/04/2005

Expiration Date

01/31/2005

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/15/2005