MICHELE ELAINE SAMPLE Respiratory Care Practitioner License verification

Business Entity

NOT RENEWED

License Type

Respiratory Care Practitioner

Description

RESPIRATORY CARE PRACTITIONER

License Number

194004672

License Status

NOT RENEWED

Business

First Name

MICHELE

Middle

ELAINE

Last Name

SAMPLE

Business Name

MICHELE ELAINE SAMPLE

Original Issue Date

03/26/2001

Effective Date

11/03/2003

Expiration Date

10/31/2005

City

DEER CREEK

State

Zip

61733

County

TAZEWELL

Ever Disciplined

LastModifiedDate

12/22/2005