Jane Denise Formantes Icuspit
ActiveCalifornia license 637523
License
- Licensed by
- California Board of Registered Nursing
- License number
- 637523
- Status
- Active (Current)
- First issued
- May 24, 2004
- Expires
- February 29, 2028
- License holder
- Jane Denise Formantes Icuspit
- Entity type
- Individual
Classifications
- Registered Nurse Nursing
More from the license record
- License type code
- 4001
Contact
14444 Terra Bella St Unit 117
Panorama City, CA 91402-1594
Panorama City, CA 91402-1594
Los Angeles County