TARA L NICKELSEN Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043088851

License Status

NOT RENEWED

Business

First Name

TARA

Middle

Last Name

NICKELSEN

Business Name

TARA L NICKELSEN

Original Issue Date

09/09/2003

Effective Date

11/30/2004

Expiration Date

01/31/2007

City

WYANET

State

Zip

61379

Ever Disciplined

LastModifiedDate

03/16/2007