PHYLLIS DEAN BURCHAM Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043030170

License Status

INACTIVE

Business

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

City

NEW DOUGLAS

State

Zip

62074

County

MADISON

Ever Disciplined

LastModifiedDate

11/03/2010