MIA M GUSTAFSON Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043122869

License Status

NOT RENEWED

Business

First Name

MIA

Middle

Last Name

GUSTAFSON

Business Name

MIA M GUSTAFSON

Original Issue Date

08/18/2016

Effective Date

12/05/2016

Expiration Date

01/31/2019

City

ROCK FALLS

State

Zip

61071

Ever Disciplined

LastModifiedDate

03/28/2019