LISA LIDE BROCKINGTON Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041504506

License Status

NOT RENEWED

Business

First Name

LISA

Middle

LIDE

Last Name

BROCKINGTON

Business Name

LISA LIDE BROCKINGTON

BusinessDBA

LISA MICHELLE LIDE

Original Issue Date

01/15/2021

Effective Date

01/15/2021

Expiration Date

08/31/2022

City

COLUMBIA

State

Zip

29229

Ever Disciplined

LastModifiedDate

03/09/2026