BEULAH SAMPLE Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043035113

License Status

INACTIVE

Business

First Name

BEULAH

Last Name

SAMPLE

Business Name

BEULAH SAMPLE

Original Issue Date

07/01/1974

City

HOFFMAN ESTATES

State

Zip

60172

County

COOK

Ever Disciplined

LastModifiedDate

10/21/2005