LEORTRICE MACK - Registered Nurse License in Illinois | # 043035646

LEORTRICE MACK

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043035646

License Status

INACTIVE

Business

N

First Name

LEORTRICE

Last Name

MACK

Business Name

LEORTRICE MACK

Original Issue Date

09/11/1974

Effective Date

12/20/2004

Expiration Date

01/31/2005

State

IL

Ever Disciplined

N

LastModifiedDate

10/15/2005