Mary Diane Fortmann
ExpiredCalifornia license 611530
License
- Licensed by
- California Board of Registered Nursing
- License number
- 611530
- Status
- Expired (Delinquent)
- First issued
- January 7, 2003
- Expired
- October 31, 2008
- License holder
- Mary Diane Fortmann
- Entity type
- Individual
Classifications
- Registered Nurse Nursing
More from the license record
- License type code
- 4001
Contact
334 2 Ashford Circle
Bartlett, IL 60103
Bartlett, IL 60103
Cook County