HAZEL ANISE FORT Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043026694

License Status

NOT RENEWED

Business

First Name

HAZEL ANISE

Last Name

FORT

Business Name

HAZEL ANISE FORT

Original Issue Date

04/13/1970

Expiration Date

01/31/1993

City

CHICAGO

State

Zip

60649

County

COOK

Ever Disciplined

LastModifiedDate

10/21/2005