DIANE C BURGESS Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043089504

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

Last Name

BURGESS

Business Name

DIANE C BURGESS

Original Issue Date

01/22/2004

Effective Date

03/04/2005

Expiration Date

01/31/2005

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

10/21/2005