STACEY J ANTONIO Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043075629

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

Last Name

ANTONIO

Business Name

STACEY J ANTONIO

Original Issue Date

06/01/1994

Effective Date

03/04/2005

Expiration Date

01/31/2005

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/15/2005