KELLY SUSAN PROVENCHER Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041504507

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

SUSAN

Last Name

PROVENCHER

Business Name

KELLY SUSAN PROVENCHER

Original Issue Date

01/15/2021

Effective Date

01/15/2021

Expiration Date

08/31/2022

City

EDINBURG

State

Zip

16116

Ever Disciplined

LastModifiedDate

10/14/2022