THEA A MELLENTINE Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043090975

License Status

NOT RENEWED

Business

First Name

THEA

Middle

Last Name

MELLENTINE

Business Name

THEA A MELLENTINE

Original Issue Date

01/19/2005

Effective Date

01/19/2005

Expiration Date

01/31/2007

City

GRANVILLE

State

Zip

61326

County

PUTNAM

Ever Disciplined

LastModifiedDate

03/16/2007