MARILYN L FORTNER Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043069263

License Status

NOT RENEWED

Business

First Name

MARILYN L

Last Name

FORTNER

Business Name

MARILYN L FORTNER

Original Issue Date

12/21/1990

Effective Date

03/04/2003

Expiration Date

01/31/2003

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/15/2005