TIMOTHY J BROCKWAY Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043119262

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

Last Name

BROCKWAY

Business Name

TIMOTHY J BROCKWAY

Original Issue Date

08/19/2014

Effective Date

01/30/2017

Expiration Date

01/31/2019

City

SOUTH BELOIT

State

Zip

61080

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

03/28/2019