KEITH EDWARD MASTALIO Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043032030

License Status

NOT RENEWED

Business

First Name

KEITH EDWARD

Last Name

MASTALIO

Business Name

KEITH EDWARD MASTALIO

Original Issue Date

12/13/1972

City

LASALLE

State

Zip

61301

County

LA SALLE

Ever Disciplined

LastModifiedDate

10/21/2005