RANDELL W ELLIS Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043100208

License Status

NOT RENEWED

Business

First Name

RANDELL

Middle

Last Name

ELLIS

Business Name

RANDELL W ELLIS

Original Issue Date

08/18/2005

Effective Date

11/03/2006

Expiration Date

01/31/2009

City

NEW DOUGLAS

State

Zip

62074

County

MADISON

Ever Disciplined

LastModifiedDate

03/17/2009