Wisconsin
Department of Safety and Professional Services
Walport, Manivanh
Registered Nurse
License number
137373-30
Date granted
07/17/2002
Date expires
02/29/2016
Class
Registered Nurse
Status
Active
Address
nursingwisconsin.org
ID 18841894
LAST UPDATED 2026-03-18 13:49:42 UTC
LAST UPDATED 2026-03-18 13:49:42 UTC
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