PENNY JO VILLALVA Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041451586

License Status

NOT RENEWED

Business

First Name

PENNY

Middle

Last Name

VILLALVA

Business Name

PENNY JO VILLALVA

Original Issue Date

03/22/2017

Effective Date

05/05/2020

Expiration Date

08/31/2022

City

LAKE OZARK

State

Zip

65049

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/14/2022