| Name | WAYNE SHROCK |
| City/State |
| License and Registration Information | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Credential | License Type | Original Issue | Issue Date | Expiration Date | Status | Discipline | How issued | Description | |||||||
| IP.406353-ENDS | Practical Nurse - Temporary Work Permit | 12/28/2001 | 06/28/2002 | Application Abandoned | |||||||||||