STEPHANIE RENEE FORMHALS Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041421704

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

RENEE

Last Name

FORMHALS

Business Name

STEPHANIE RENEE FORMHALS

Original Issue Date

07/18/2014

Effective Date

05/01/2022

Expiration Date

06/30/2024

City

TROY

State

Zip

63379

Ever Disciplined

LastModifiedDate

03/23/2026