NATHALIE KAE DIETHRICH Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209014716

License Status

INACTIVE

Business

First Name

NATHALIE

Middle

KAE

Last Name

DIETHRICH

Business Name

NATHALIE KAE DIETHRICH

Original Issue Date

08/17/2016

Effective Date

04/21/2020

Expiration Date

05/31/2022

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

04/21/2020