BRENDA FAY STACK Respiratory Care Practitioner License verification

Business Entity

NOT RENEWED

License Type

Respiratory Care Practitioner

Description

RESPIRATORY CARE PRACTITIONER

License Number

194000241

License Status

NOT RENEWED

Business

First Name

BRENDA

Middle

FAY

Last Name

STACK

Business Name

BRENDA FAY STACK

Original Issue Date

10/31/1997

Effective Date

09/08/2009

Expiration Date

10/31/2011

City

SANDWICH

State

Zip

60548

County

DEKALB

Ever Disciplined

LastModifiedDate

12/07/2011