TARA L CRUMBLE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****04

License Status

ACTIVE

Business

First Name

TARA

Middle

Last Name

CRUMBLE

Business Name

TARA L CRUMBLE

Original Issue Date

01/03/2017

Effective Date

05/01/2024

Expiration Date

05/31/2026

City

METROPOLIS

State

Zip

62960

County

MASSAC

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026