STACEY M BAST Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043087181

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

Last Name

BAST

Business Name

STACEY M BAST

Original Issue Date

03/12/2002

Effective Date

11/13/2020

Expiration Date

01/31/2023

City

CHESTER

State

Zip

62233

County

RANDOLPH

Ever Disciplined

LastModifiedDate

03/31/2023