TINA RENEE VACLAVIK Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041340166

License Status

NOT RENEWED

Business

First Name

TINA

Middle

RENEE

Last Name

VACLAVIK

Business Name

TINA RENEE VACLAVIK

Original Issue Date

06/03/2004

Effective Date

06/03/2004

Expiration Date

05/31/2006

City

PORTAGE

State

Zip

46368

County

INDIANA

Ever Disciplined

LastModifiedDate

10/09/2006