Vivan Grace Taylor Jackson
ExpiredCalifornia license 623964
License
- Licensed by
- California Board of Registered Nursing
- License number
- 623964
- Status
- Expired (Delinquent)
- First issued
- August 12, 2003
- Expired
- July 31, 2005
- License holder
- Vivan Grace Taylor Jackson
- Entity type
- Individual
Classifications
- Registered Nurse Nursing
More from the license record
- License type code
- 4001
Contact
1521 Seward Drive
Johnson City, TN 37604
Johnson City, TN 37604
Washington County