TIFFANY A BROUSSARD Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043114884

License Status

INACTIVE

Business

First Name

TIFFANY

Middle

Last Name

BROUSSARD

Business Name

TIFFANY A BROUSSARD

Original Issue Date

06/20/2012

Effective Date

02/11/2015

Expiration Date

01/31/2017

City

DYER

State

Zip

46311

County

INDIANA

Ever Disciplined

LastModifiedDate

11/10/2016