EDITH M THEODATE
Nursing at Legacy Park Dr, Lawrenceville, GA

License number
Florida 206442
Issued Date
Jan 7, 2010
Effective Date
Jan 15, 2013
Expiration Date
Dec 31, 2010
Category
Health Care
Type
Certified Nursing Assistant
Address
Address
900 Legacy Park Dr APT #1517, Lawrenceville, GA 30043
Phone
(770) 676-6643
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

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