CRYSTAL SUE CLARK Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209017069

License Status

INACTIVE

Business

First Name

CRYSTAL

Middle

SUE

Last Name

CLARK

Business Name

CRYSTAL SUE CLARK

Original Issue Date

01/03/2018

Effective Date

09/02/2020

Expiration Date

05/31/2022

City

MONTICELLO

State

Zip

61856

County

PIATT

Ever Disciplined

LastModifiedDate

09/02/2020