MILENA TRACI MASK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****34

License Status

NOT RENEWED

Business

First Name

MILENA

Middle

TRACI

Last Name

MASK

Business Name

MILENA TRACI MASK

Original Issue Date

07/19/2017

Effective Date

06/05/2018

Expiration Date

09/30/2020

City

MARIETTA

State

Zip

30064

Delegated Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021