ELLEN MOORE MASON Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043039104

License Status

NOT RENEWED

Business

First Name

ELLEN MOORE

Last Name

MASON

Business Name

ELLEN MOORE MASON

Original Issue Date

01/06/1976

Effective Date

04/04/2005

Expiration Date

01/31/2005

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

06/02/2005

Case Number

2003001928

Action

Fine

Discipline Start Date

04/04/2005