DIESAWIT T HANSOM Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209026574

License Status

INACTIVE

Business

First Name

DIESAWIT

Middle

Last Name

HANSOM

Business Name

DIESAWIT T HANSOM

Original Issue Date

12/14/2022

Effective Date

04/07/2024

Expiration Date

05/31/2026

City

LAKE VILLA

State

Zip

60046

County

LAKE

Ever Disciplined

LastModifiedDate

05/29/2025