NamePHYLLIS ANITA JACKSON
City/State

License and Registration Information
CredentialLicense TypeOriginal IssueIssue DateExpiration DateStatusDisciplineHow issuedDescription
PN.065901-MEDS Licensed Practical Nurse - MEDS 11/30/1981 08/01/1984 08/31/1986 LAPSED Examination
RN.201522- Registered Nurse 03/19/1986 04/27/1998 08/31/1999 LAPSED Examination

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