CONNIE M BERGFELD Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043080221

License Status

NOT RENEWED

Business

First Name

CONNIE

Middle

Last Name

BERGFELD

Business Name

CONNIE M BERGFELD

Original Issue Date

11/19/1996

Effective Date

03/04/2005

Expiration Date

01/31/2005

City

ENERGY

State

Zip

62933

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

10/15/2005