ELENA C PENA Respiratory Care Practitioner License verification

Business Entity

INACTIVE

License Type

Respiratory Care Practitioner

Description

RESPIRATORY CARE PRACTITIONER

License Number

194003765

License Status

INACTIVE

Business

First Name

ELENA

Middle

Last Name

PENA

Business Name

ELENA C PENA

Original Issue Date

11/08/1999

Effective Date

10/09/2003

Expiration Date

10/31/2005

City

ROCKFORD

State

Zip

61102

Ever Disciplined

LastModifiedDate

09/09/2005