3b. Licenses (include copy with number & expiration date)

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STATE OF LICENSURE

LICENSE TYPE

LICENSE #

STATUS

ISSUE DATE

EXPIRATION DATE

DISCIPLINE

MISSOURI

RN

2015013828

ACTIVE MULTI-STATE

05/06/2015

04/30/2017

NO

CALIFORNIA

RN

95103439

ACTIVE

08/31/2016

05/31/2018

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