CHANEL C LATHAM Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043086865

License Status

NOT RENEWED

Business

First Name

CHANEL

Middle

Last Name

LATHAM

Business Name

CHANEL C LATHAM

Original Issue Date

11/29/2001

Effective Date

12/01/2004

Expiration Date

01/31/2007

City

WEST PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

03/16/2007