MELINDA KOONTZ BROKAW Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043077837

License Status

NOT RENEWED

Business

First Name

MELINDA

Middle

KOONTZ

Last Name

BROKAW

Business Name

MELINDA KOONTZ BROKAW

Original Issue Date

09/06/1995

Expiration Date

01/31/1997

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Ever Disciplined

LastModifiedDate

10/21/2005