NameGWENDOLYN MOOREHEAD
City/State

License and Registration Information
CredentialLicense TypeOriginal IssueIssue DateExpiration DateStatusDisciplineHow issuedDescription
DT.00653- Ohio Certified Dialysis Technician 02/21/2002 03/07/2003 03/31/2005 LAPSED
PN.139088-M-IV Licensed Practical Nurse - M-IV 03/23/2010 07/01/2014 08/31/2016 ACTIVE Examination
TC1.00653- Temporary Dialysis Certificate 1 01/09/2001 01/09/2001 01/19/2002 EXPIRED

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