AMANDA S DALASKA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****10

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

DALASKA

Business Name

AMANDA S DALASKA

Original Issue Date

08/15/2014

Effective Date

06/30/2020

Expiration Date

08/31/2022

City

CORDOVA

State

Zip

61242

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022