GEORGINA W FORMACION Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043122760

License Status

NOT RENEWED

Business

First Name

GEORGINA

Middle

Last Name

FORMACION

Business Name

GEORGINA W FORMACION

Original Issue Date

07/28/2016

Effective Date

01/25/2017

Expiration Date

01/31/2019

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Ever Disciplined

LastModifiedDate

03/28/2019