NANCY THIBAULT WIEMERS Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****00

License Status

INACTIVE

Business

First Name

NANCY THIBAULT

Last Name

WIEMERS

Business Name

NANCY THIBAULT WIEMERS

Original Issue Date

06/15/2004

Effective Date

03/13/2020

Expiration Date

08/31/2022

City

PEORIA

State

Zip

61614

County

PEORIA

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/04/2022