TRACY L PETERSON Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209005309

License Status

INACTIVE

Business

First Name

TRACY L

Last Name

PETERSON

Business Name

TRACY L PETERSON

Original Issue Date

10/04/2004

Effective Date

09/01/2020

Expiration Date

08/31/2022

City

MONTICELLO

State

Zip

61856

County

PIATT

Ever Disciplined

LastModifiedDate

08/30/2022