JAY DIETRICH Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209021931

License Status

ACTIVE

Business

First Name

JAY

Last Name

DIETRICH

Business Name

JAY DIETRICH

Original Issue Date

09/02/2020

Effective Date

03/07/2024

Expiration Date

05/31/2026

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

03/02/2026