PHYLLIS DEAN BURCHAM - Registered Nurse License in Illinois | # 043030170

PHYLLIS DEAN BURCHAM

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043030170

License Status

INACTIVE

Business

N

First Name

PHYLLIS DEAN

Last Name

BURCHAM

Business Name

PHYLLIS DEAN BURCHAM

Original Issue Date

03/02/1972

Effective Date

12/29/2008

Expiration Date

01/31/2011

State

IL

Ever Disciplined

N

LastModifiedDate

11/03/2010