LEE A PETAK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209007167

License Status

ACTIVE

Business

First Name

LEE A

Last Name

PETAK

Business Name

LEE A PETAK

Original Issue Date

07/29/2008

Effective Date

03/11/2024

Expiration Date

05/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

03/02/2026