THEA-DANE P MARTIN Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043121635

License Status

NOT RENEWED

Business

First Name

THEA-DANE

Middle

Last Name

MARTIN

Business Name

THEA-DANE P MARTIN

Original Issue Date

10/14/2015

Effective Date

01/02/2019

Expiration Date

01/31/2021

City

JACKSON

State

Zip

63755

Ever Disciplined

LastModifiedDate

03/11/2021