SHIRLEY A ROTH Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043034410

License Status

NOT RENEWED

Business

First Name

SHIRLEY A

Last Name

ROTH

Business Name

SHIRLEY A ROTH

Original Issue Date

02/22/1974

Effective Date

03/04/2003

Expiration Date

01/31/2003

City

OTTAWA

State

Zip

61350

County

LA SALLE

Ever Disciplined

LastModifiedDate

10/15/2005