SCOTT W DIDERICH Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043085539

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

Last Name

DIDERICH

Business Name

SCOTT W DIDERICH

Original Issue Date

10/26/2000

Effective Date

03/04/2003

Expiration Date

01/31/2003

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/21/2005