CHARLENE M MANTOCK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041175939

License Status

NOT RENEWED

Business

First Name

CHARLENE M

Last Name

MANTOCK

Business Name

CHARLENE M MANTOCK

Original Issue Date

10/12/1977

Effective Date

10/12/1977

Expiration Date

05/31/1990

City

FORT WAYNE

State

Zip

46804

County

INDIANA

Ever Disciplined

LastModifiedDate

09/27/2006