SANDRA A CLARK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043082133

License Status

NOT RENEWED

Business

First Name

SANDRA

Middle

Last Name

CLARK

Business Name

SANDRA A CLARK

Original Issue Date

03/23/1998

Effective Date

12/08/2000

Expiration Date

01/31/2001

City

LOVES PARK

State

Zip

61115

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

06/02/2005

Case Number

1999005334

Action

Suspension

Discipline Start Date

12/08/2000

Discipline Reason

Diverted Vicodin, Xanax and Darvocet from patients at River Bluff Nursing Home in Rockford.