Randall Lake
ExpiredCalifornia license 512259
License
- Licensed by
- California Board of Registered Nursing
- License number
- 512259
- Status
- Expired (Delinquent)
- First issued
- June 27, 1995
- Expired
- August 31, 2016
- License holder
- Randall Lake
- Entity type
- Individual
Classifications
- Registered Nurse Nursing
More from the license record
- License type code
- 4001
Contact
135 Manor Rd
Fairfax, CA 94930-1508
Fairfax, CA 94930-1508
Marin County