TRACY R JACKSON Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043082174

License Status

NOT RENEWED

Business

First Name

TRACY

Middle

Last Name

JACKSON

Business Name

TRACY R JACKSON

Original Issue Date

04/02/1998

Effective Date

02/08/2011

Expiration Date

01/31/2013

City

SHIPMAN

State

Zip

62685

County

MACOUPIN

Ever Disciplined

LastModifiedDate

03/20/2013