SUSAN J SMITH Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043079242

License Status

NOT RENEWED

Business

First Name

SUSAN J

Last Name

SMITH

Business Name

SUSAN J SMITH

Original Issue Date

05/18/1996

Effective Date

08/21/2003

Expiration Date

01/31/2005

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/15/2005

Case Number

2001007862

Action

Suspension

Discipline Start Date

08/21/2003

Discipline Reason

Failed to administer medications to two residents while assigned by a staffing agency to work at Belvidere Health Care Center.