TIFFANY A STORK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209012504

License Status

ACTIVE

Business

First Name

TIFFANY

Middle

Last Name

STORK

Business Name

TIFFANY A STORK

Original Issue Date

01/27/2015

Effective Date

05/13/2024

Expiration Date

05/31/2026

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Ever Disciplined

LastModifiedDate

03/02/2026