SANDRA RAE THOMPSON 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

SANDRA

Middle

RAE

Last Name

THOMPSON

Business Name

SANDRA RAE THOMPSON

Original Issue Date

11/29/2018

Effective Date

11/29/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021