JODY M FACKELMAN Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041338861

License Status

INACTIVE

Business

First Name

JODY

Middle

Last Name

FACKELMAN

Business Name

JODY M FACKELMAN

Original Issue Date

01/28/2004

Effective Date

01/28/2004

Expiration Date

05/31/2008

City

EDWARDSBURG

State

Zip

49112

County

MICHIGAN

Ever Disciplined

LastModifiedDate

03/11/2008