SUSAN ARLENE VIVIAN Respiratory Care Practitioner License verification

Business Entity

INACTIVE

License Type

Respiratory Care Practitioner

Description

RESPIRATORY CARE PRACTITIONER

License Number

194005599

License Status

INACTIVE

Business

First Name

SUSAN

Middle

ARLENE

Last Name

VIVIAN

Business Name

SUSAN ARLENE VIVIAN

Original Issue Date

02/24/2004

Effective Date

11/01/2005

Expiration Date

10/31/2007

City

POLO

State

Zip

61064

County

CARROLL

Ever Disciplined

LastModifiedDate

08/07/2007