ALTA M GUNAWAN Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043108240

License Status

NOT RENEWED

Business

First Name

ALTA

Middle

Last Name

GUNAWAN

Business Name

ALTA M GUNAWAN

Original Issue Date

07/17/2009

Effective Date

01/11/2021

Expiration Date

01/31/2023

City

NEPONSET

State

Zip

61345

County

BUREAU

Ever Disciplined

LastModifiedDate

03/31/2023