KEITH SAMUEL BASS Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209015848

License Status

INACTIVE

Business

First Name

KEITH

Middle

SAMUEL

Last Name

BASS

Business Name

KEITH SAMUEL BASS

Original Issue Date

04/06/2017

Effective Date

08/09/2022

Expiration Date

05/31/2024

City

ANNA

State

Zip

62906

County

UNION

Ever Disciplined

LastModifiedDate

03/31/2023