BRENDA JEAN POLIVKA Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041175604

License Status

NOT RENEWED

Business

First Name

BRENDA JEAN

Last Name

POLIVKA

Business Name

BRENDA JEAN POLIVKA

Original Issue Date

10/12/1977

Effective Date

04/10/2018

Expiration Date

09/30/2020

City

VALPARAISO

State

Zip

46385

County

INDIANA

Ever Disciplined

LastModifiedDate

01/14/2021