REZA DIWATA BERNARDINO Registered Nurse License verification

Business Entity

ACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043134135

License Status

ACTIVE

Business

First Name

REZA

Middle

DIWATA

Last Name

BERNARDINO

Business Name

REZA DIWATA BERNARDINO

Original Issue Date

08/25/2023

Effective Date

12/04/2024

Expiration Date

01/31/2027

City

BARTLETT

State

Zip

60103

Ever Disciplined

LastModifiedDate

12/04/2024