Person Information

Name:MARJORIE MANTLE FARMER

Address Information

Address(city state zipcode):WATERTOWN NY13601

License Information

Type:Certified Registered Nurse PractitionerSecondary Type:Adult HealthNumber:VP002133C
Profession:NursingStatus:InactiveDate This Status:9/23/1999
Issue Date:7/28/1993Expires:10/31/1999Last Renewed:9/23/1997

Prerequisite Information

Licensee:FARMER, MARJORIE MANTLERelationship:Self Automatic
Type:Registered NurseNumber:RN329201LStatus:Inactive
Date of Association:Date of Expiration:

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