TAMARRA L SUBYANTORO Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209019900

License Status

ACTIVE

Business

First Name

TAMARRA

Middle

Last Name

SUBYANTORO

Business Name

TAMARRA L SUBYANTORO

Original Issue Date

08/22/2019

Effective Date

03/21/2024

Expiration Date

05/31/2026

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

03/02/2026