HEIDI NOEL COOK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****06

License Status

NOT RENEWED

Business

First Name

HEIDI

Middle

NOEL

Last Name

COOK

Business Name

HEIDI NOEL COOK

Original Issue Date

06/14/2018

Effective Date

09/08/2020

Expiration Date

08/31/2022

City

PEORIA

State

Zip

61606

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022