| Name: |
TITA TOLEDO MEDINA |
| DBA: |
|
| License Number: |
653 |
| License Type: |
IS A CERTIFIED NURSE AIDE |
| Status: |
ABUSE REGISTERY Nurse Aide Program |
| Address: |
714 THORSHEIM STREET KODIAK AK 99615
|
| Expiration Date: |
03/31/1994 |
| Current Issue Date: |
03/03/1992 |
| First Issue Date: |
11/13/1990 |
| Additional Info: |
SUBSTANTIATED COMPLAINT OF ABUSE TO HAVE OCCURRED APRIL-JUNE 1993 WHILE EMPLOYED AT KODIAK ISLAND HOSPITAL
LONG TERM CARE. L ETTER REGARDING THIS COMPLAINT FILED 3/22/95 PER 42 CFR PART 483 .156(C)IV. |
|
|
|
This license has
been the subject of a formal agreement, order or disciplinary
action. Contact the
division for more information. |
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