PHYLLIS A MOSS Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043054904

License Status

NOT RENEWED

Business

First Name

PHYLLIS A

Last Name

MOSS

Business Name

PHYLLIS A MOSS

Original Issue Date

09/23/1982

Expiration Date

01/31/1995

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/21/2005