JAN KEVIN B FORMALES Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043122934

License Status

NOT RENEWED

Business

First Name

JAN KEVIN

Middle

Last Name

FORMALES

Business Name

JAN KEVIN B FORMALES

Original Issue Date

08/24/2016

Effective Date

02/04/2019

Expiration Date

01/31/2021

City

PINGREE GROVE

State

Zip

60140

County

KANE

Ever Disciplined

LastModifiedDate

03/11/2021