JACK P BANTA
Nursing at Disston Ave, Tavares, FL

License number
Florida 9202351
Issued Date
Jun 5, 2003
Effective Date
May 4, 2015
Expiration Date
Apr 30, 2019
Category
Health Care
Type
Registered Nurse
Address
Address
200 N Disston Ave, Tavares, FL 32778
Phone
(352) 638-7662
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

Personal information

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Name
Address
Phone
Jack Banta, age 62
200 N Disston Ave, Tavares, FL 32778
Jack P Banta, age 36
895 Mansfield Rd, Tavares, FL 32778
(352) 742-9793
Jack P Banta, age 36
200, Tavares, FL 32778
Jack P Banta, age 36
26001 Zinnia Ln, Astatula, FL 34705
(352) 742-9793
Jack P Banta, age 36
3316 Rainbow Rd, Tavares, FL 32778
(352) 742-9793

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