Professional License Details
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.