JERRY L FOZZARD Respiratory Care Practitioner License verification

Business Entity

NOT RENEWED

License Type

Respiratory Care Practitioner

Description

RESPIRATORY CARE PRACTITIONER

License Number

194004298

License Status

NOT RENEWED

Business

First Name

JERRY

Middle

Last Name

FOZZARD

Business Name

JERRY L FOZZARD

Original Issue Date

05/08/2000

Effective Date

10/03/2003

Expiration Date

10/31/2005

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Ever Disciplined

LastModifiedDate

12/22/2005