PEMERINTAH KABUPATEN BLITAR

DINAS KESEHATAN
PUSKESMAS WONOTIRTO
Jalan Raya Gawang Blitar Kode Pos 66173
Email : pkmwonotirtokabblitar@gmail.com

BUKTI SURAT IZIN SESUAI YANG DIPERSYARATKAN

NO. NAMA STR BERLAKU SIP BERLAKU KET

dr. Endah Rositaningsih, SE. MM 3521100316003060 30/12/2021 503/122/DU/409.104/VIII/2016 30/12/2021

1
Yle Purwanti, S. Sos STRUKTURAL
2
drg. Yogi Rinaldi 3512100215115870.00 15/12/2020 503/10/Drg/409.104/XII/2015 28/12/2015
3
dr. Dendy Dwi Ramadhani 3511100112127300 18/01/2017 503/19/DU/409.104/V/2015 18/01/2015
4
M. Syaefudin Z, A.Md. Kep P2T/5967/03.02/02/VI/2013 05-07-2018 503/1/SIPP/409/104/11/2013 05-07-18
5
Samsul Hadi, S.Kep. Ns P2T/3885/03.02/01/IV/2012 15/5/2017 503/19/SIPP/409.104/VII/2014 15/5/2017
6
Pudji Setio Rahayu STRUKTURAL
7
Sudrajat Harianto, Amd, Gz P2T/773/03.10/101/VI/2012 17/12/2017
8
9 Anik Sugeng Rahayu, AMd. Kep P2T/2417/03.02/02/11/2014 28/6/2019 503/41/SIPP/409.104/XII/2014 28/6/2019
Woro Setyorini, S.ST P2T/5488/03.01/01/VII/2012 12-10-17 503/38/SIPB/409/10/IV/2013 12-10-17
10
A'is Dwi Wahyuningtyas, S.ST P2T/8151/03.01/01/XII/2012 19/12/2017 503/37/SIPB/409/104/IV/2013 29/12/2017
11
Titin Mulyati, S.ST P2T/5490/03.01/01/VII/2012 20/5/2017 503/39/SIPB/409/104/V/2013 20/5/2017
12
Santi Lestarini, AMd. Keb P2T/5489/03.01/01/VII/2012 30/5/2017 503/41/SIPB/409.104/V/2013 30/5/2017
13
Sri Utami, AMd. Keb P2T/6640/03.01/01/VI/2013 22/4/2018 503/59/SIPB/409.104/VII/2013 22/4/2018
14
 Endang Sri Eni Riwayati, AMd. Keb P2T/6641/03.01/01/VI/2013 23/10/2018 503/63/SIPB/409.104/VII/2013 23/10/2018
15
Eni Wahyuningsih, AMd. Kep P2T/2404/03.02/02/11/2014 503/4/SIPP/409.104/X/2016
16
Yulis Setyaningsih, AMd. Keb P2T/6644/03.01/01/VI/2013 07-09-18 503/63/SIPB/409/104/VII/2013 23/10/2018
17
Narwiyah, AMd. Keb P2T/6643/03.01/01/VI/2013 26/12/2018 503/62/SIPB/409.104/VII/2013 26/12/2018
18
Hermin Narfiah, AMd, Kep P2T/5276/03.02/02/IV/2013 09-10-18
19
Basuki Rahmad P2T/5728/03.02/01/VI/2012 20/4/2017
20
Yeni Sulastri, AMd. Keb P2T/6642/03.01/02/VI/2013 27/9/2018 503/60/SIPB/409.104/VII/2013 27/9/2018
21
Suryaningsih, AMd. Kep P2T/2533/03.02/02/111/2016 22/7/2021
22
Ike Lusia, AMd. Kep P2T/2503/03.02/02/I11/2016 02-08-21
23
Waluyo Yoga S, AMd. Kep P2T/6632/03.02/02/IX/2016 05-03-21 503/14/SIPP/409.104/VI/2014
24
Widi Astuti, AMd, Farm P2T/813/03.06/01/X/2016 16/04/2021
25
Tanti Widiarsih, AMd, Keb P2T8906/03.01/02/XII/2014 08-09-19
26
Dhanis Seprisa P. STr, Keb P2T/1104/03.01/02/11/2016 09-06-21
27
Neni Oktasari, AMd, Keb P2T/6737/03.01/01/XI/2012 17/10/2017
28
Sandra Sabgi Pratiwi, AMd, Keb P2T/2847/03.01/01/III/2015 22/05/2020
29
Nurlia Fauza, S.Kep. Ns P2T/5086/03.02/01/VII/2016 03-09-21
30
Srivindah Handayani, AMd, Keb P2T/8920/03.01/01/XI/2013 18/04/2018
31
Yeni Oktavia W, AMd, Keb P2T/6344/03.01/01/V/2015 22/10/2020
32
Asih Sri Lestari, AMd, Keb P2T/5021/03.01/01/VIII/2017 07-10-22
33
Anis Novitasari, AMd, Keb P2T/5037/03.01/01/VIII/2017 03-12-22
34
35 Dewi Malikatus Subkhiyah, AMd, Keb P2T/5019/03.01/01/VII/2017 02-09-22
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