ELLEN J WAGNER Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043011124

License Status

NOT RENEWED

Business

First Name

ELLEN J

Last Name

WAGNER

Business Name

ELLEN J WAGNER

Original Issue Date

04/01/1963

Expiration Date

05/01/1982

City

BELOIT

State

Zip

53511

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/21/2005