Dorothy L Provine
InactiveIllinois license 041038367
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 041038367
- Status
- Inactive
- First issued
- January 1, 1997
- Expired
- May 31, 1996
- License holder
- Dorothy L Provine
- Entity type
- Individual
Classifications
- Registered Professional Nurse (Nursing Board) Nursing
Contact
Macomb, IL 61455
McDonough County