GARY J FORSETH Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043070757

License Status

INACTIVE

Business

First Name

GARY

Middle

Last Name

FORSETH

Business Name

GARY J FORSETH

Original Issue Date

01/16/1992

Effective Date

11/14/2002

Expiration Date

01/31/2003

City

GLEN CARBON

State

Zip

62032

County

MADISON

Ever Disciplined

LastModifiedDate

10/15/2005