AMANDA NICHOLE FORTMAN Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041375237

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

NICHOLE

Last Name

FORTMAN

Business Name

AMANDA NICHOLE FORTMAN

Original Issue Date

04/09/2009

Effective Date

04/09/2009

Expiration Date

05/31/2010

City

DAYTON

State

Zip

45403

County

OHIO

Ever Disciplined

LastModifiedDate

08/16/2010