TARA L GUSTAFSON - Registered Nurse License in Illinois | # 043064068

TARA L GUSTAFSON

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043064068

License Status

NOT RENEWED

Business

N

First Name

TARA

Middle

L

Last Name

GUSTAFSON

Business Name

TARA L GUSTAFSON

Original Issue Date

01/17/1987

Effective Date

03/04/2005

Expiration Date

01/31/2005

State

IL

Ever Disciplined

N

LastModifiedDate

10/15/2005