STACIE L KETCHAM Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043078851

License Status

NOT RENEWED

Business

First Name

STACIE

Middle

Last Name

KETCHAM

Business Name

STACIE L KETCHAM

Original Issue Date

01/22/1996

Effective Date

01/20/2015

Expiration Date

01/31/2017

City

LINCOLN

State

Zip

62656

County

LOGAN

Ever Disciplined

LastModifiedDate

03/27/2017