SAMUEL T LOGAN Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209013219

License Status

INACTIVE

Business

First Name

SAMUEL

Middle

Last Name

LOGAN

Business Name

SAMUEL T LOGAN

Original Issue Date

08/25/2015

Effective Date

05/23/2018

Expiration Date

09/30/2020

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

03/12/2018