ANGELA M BURCHAM Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043058081

License Status

NOT RENEWED

Business

First Name

ANGELA

Middle

Last Name

BURCHAM

Business Name

ANGELA M BURCHAM

Original Issue Date

12/27/1983

Effective Date

03/04/2005

Expiration Date

01/31/2005

City

MOWEAQUA

State

Zip

62550

County

SHELBY

Ever Disciplined

LastModifiedDate

10/15/2005