TARISA K CHAMPION Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043082405

License Status

INACTIVE

Business

First Name

TARISA

Middle

Last Name

CHAMPION

Business Name

TARISA K CHAMPION

Original Issue Date

06/30/1998

Effective Date

11/13/2002

Expiration Date

01/31/2003

City

CARMI

State

Zip

62821

County

WHITE

Ever Disciplined

LastModifiedDate

10/15/2005