License holder summary

JACQUELINE ANNE UNTALAN is a Nurse Registered & Licensed Practical - Lpn licensed to practice in Michigan. The address on file for JACQUELINE ANNE UNTALAN is Crystal Falls, MI 49920. This licensed professional license is not current. The license was granted 12/29/1969 and expired on 03/31/2004.

Michigan

Department of Licensing and Regulation

JACQUELINE ANNE UNTALAN
Nurse Registered & Licensed Practical - Lpn
License number
4703025523
Date granted
12/29/1969
Date expires
03/31/2004
Class
Nurse Registered & Licensed Practical - Lpn
Status
Lapsed
Address
Crystal Falls, MI 49920
michiganlicensing.org
ID 25819325
LAST UPDATED 2024-03-26 20:01:00 UTC

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