NICOLE LYNN FORD Respiratory Care Practitioner License verification

Business Entity

NOT RENEWED

License Type

Respiratory Care Practitioner

Description

RESPIRATORY CARE PRACTITIONER

License Number

194005061

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

LYNN

Last Name

FORD

Business Name

NICOLE LYNN FORD

Original Issue Date

04/15/2002

Effective Date

10/21/2013

Expiration Date

10/31/2015

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

12/09/2015