TIMOTHY A DEMING Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****01

License Status

NOT RENEWED

Business

First Name

TIMOTHY A

Last Name

DEMING

Business Name

TIMOTHY A DEMING

Original Issue Date

07/13/2011

Effective Date

04/20/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021