RAVEN LACHEA GILLOM Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043114881

License Status

NOT RENEWED

Business

First Name

RAVEN

Middle

LACHEA

Last Name

GILLOM

Business Name

RAVEN LACHEA GILLOM

Original Issue Date

06/20/2012

Effective Date

01/30/2017

Expiration Date

01/31/2019

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

03/28/2019