MELANIE J DERRICKSON Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043090605

License Status

NOT RENEWED

Business

First Name

MELANIE

Middle

Last Name

DERRICKSON

Business Name

MELANIE J DERRICKSON

Original Issue Date

11/09/2004

Effective Date

11/03/2006

Expiration Date

01/31/2009

City

SHELBYVILLE

State

Zip

62565

County

SHELBY

Ever Disciplined

LastModifiedDate

03/17/2009