HENRIETTA M BROUSSARD Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043019159

License Status

NOT RENEWED

Business

First Name

HENRIETTA M

Last Name

BROUSSARD

Business Name

HENRIETTA M BROUSSARD

Original Issue Date

06/06/1967

Expiration Date

01/31/1989

City

CHICAGO

State

Zip

60653

County

COOK

Ever Disciplined

LastModifiedDate

10/21/2005