| Name | TIMOTHY ALAN UPPOLE |
| City/State |
| License and Registration Information | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Credential | License Type | Original Issue | Issue Date | Expiration Date | Status | Discipline | How issued | Description | |||||||
| PN.102962-M-IV | Licensed Practical Nurse - M-IV | 07/28/1998 | 08/29/2014 | 08/31/2016 | ACTIVE | Prior Reprimand | Endorsement | ||||||||