CLARK JEFFREY INGRAM Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043124528

License Status

NOT RENEWED

Business

First Name

CLARK

Middle

JEFFREY

Last Name

INGRAM

Business Name

CLARK JEFFREY INGRAM

Original Issue Date

09/08/2017

Effective Date

01/07/2019

Expiration Date

01/31/2021

City

CHAMPAIGN

State

Zip

61822

Ever Disciplined

LastModifiedDate

03/11/2021