License holder summary

KRISTIE OTIS-MBAZOMO is a Nurse Registered & Licensed Practical - Rn Provisional licensed to practice in Michigan. The address on file for KRISTIE OTIS-MBAZOMO is Mobile, AL 36695. This licensed professional license is not current. The license was granted 07/16/2012 and expired on 07/16/2013.

Michigan

Department of Licensing and Regulation

KRISTIE OTIS-MBAZOMO
Nurse Registered & Licensed Practical - Rn Provisional
License number
4704293750
Date granted
07/16/2012
Date expires
07/16/2013
Class
Nurse Registered & Licensed Practical - Rn Provisional
Status
Voided
Address
Mobile, AL 36695
michiganlicensing.org
ID 25840931
LAST UPDATED 2026-05-28 16:46:51 UTC

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