TANIA A FORREST Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043054451

License Status

NOT RENEWED

Business

First Name

TANIA A

Last Name

FORREST

Business Name

TANIA A FORREST

Original Issue Date

07/27/1982

Effective Date

03/04/2003

Expiration Date

01/31/2003

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/15/2005