| Name | HATTIE WILLIS |
| City/State |
| License and Registration Information | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Credential | License Type | Original Issue | Issue Date | Expiration Date | Status | Discipline | How issued | Description | |||||||
| PN.016371- | Licensed Practical Nurse | 05/31/1960 | 06/24/1992 | 08/31/1994 | LAPSED | Endorsement | |||||||||