ELIZABETH M FORMAN Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043037817

License Status

INACTIVE

Business

First Name

ELIZABETH M

Last Name

FORMAN

Business Name

ELIZABETH M FORMAN

Original Issue Date

10/17/1975

Expiration Date

01/31/1997

City

RUSHVILLE

State

Zip

62681

County

SCHUYLER

Ever Disciplined

LastModifiedDate

10/21/2005