STACEY A DEITZ Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043078841

License Status

NOT RENEWED

Business

First Name

STACEY A

Last Name

DEITZ

Business Name

STACEY A DEITZ

Original Issue Date

01/13/1996

Expiration Date

01/31/1997

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

10/21/2005