KIMBERLY A MANCILLA Surgical Assistant/Technologist License verification

Business Entity

NOT RENEWED

License Type

Surgical Assistant/Technologist

Description

REGISTERED SURGICAL TECHNOLOGIST

License Number

237000119

License Status

NOT RENEWED

Business

First Name

KIMBERLY

Middle

Last Name

MANCILLA

Business Name

KIMBERLY A MANCILLA

Original Issue Date

08/29/2012

Effective Date

07/21/2020

Expiration Date

05/31/2022

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/27/2022