CAROL S REVAK Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043046371

License Status

INACTIVE

Business

First Name

CAROL S

Last Name

REVAK

Business Name

CAROL S REVAK

Original Issue Date

01/26/1979

Expiration Date

01/31/1993

City

GRANITE CITY

State

Zip

62040

County

MADISON

Ever Disciplined

LastModifiedDate

10/21/2005