PHILLIP DUSTIN DEBERRY Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209016634

License Status

NOT RENEWED

Business

First Name

PHILLIP

Middle

DUSTIN

Last Name

DEBERRY

Business Name

PHILLIP DUSTIN DEBERRY

Original Issue Date

09/21/2017

Effective Date

03/21/2018

Expiration Date

09/30/2020

City

MAKANDA

State

Zip

62958

County

JACKSON

Ever Disciplined

LastModifiedDate

01/14/2021