TIFFANY A LAKE LUCKETT Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209025453

License Status

ACTIVE

Business

First Name

TIFFANY

Middle

Last Name

LAKE LUCKETT

Prefix

Business Name

TIFFANY A LAKE LUCKETT

Original Issue Date

07/07/2022

Effective Date

03/03/2026

Expiration Date

05/31/2028

City

WARRENVILLE

State

Zip

60563

County

DUPAGE

Ever Disciplined

LastModifiedDate

03/03/2026