DIANE M CLARK Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041177074

License Status

INACTIVE

Business

First Name

DIANE M

Last Name

CLARK

Business Name

DIANE M CLARK

Original Issue Date

10/12/1977

Effective Date

04/21/2010

Expiration Date

05/31/2012

City

EDGERTON

State

Zip

53534

County

WISCONSIN

Ever Disciplined

LastModifiedDate

03/08/2012