SALLIE VAN DAELE Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****08

License Status

NOT RENEWED

Business

First Name

SALLIE

Last Name

VAN DAELE

Business Name

SALLIE VAN DAELE

Original Issue Date

02/04/2004

Effective Date

05/20/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/14/2021