LESLIE JAY FORTH Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043124300

License Status

INACTIVE

Business

First Name

LESLIE

Middle

JAY

Last Name

FORTH

Business Name

LESLIE JAY FORTH

Original Issue Date

08/07/2017

Effective Date

12/13/2018

Expiration Date

01/31/2021

City

CISNE

State

Zip

62823

County

WAYNE

Ever Disciplined

LastModifiedDate

12/11/2025