DENEICE M CROCKETT Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043078453

License Status

NOT RENEWED

Business

First Name

DENEICE M

Last Name

CROCKETT

Business Name

DENEICE M CROCKETT

Original Issue Date

06/17/1996

Effective Date

03/04/2005

Expiration Date

01/31/2005

City

MADISON

State

Zip

53713

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/15/2005