MICHELLE M THACKER Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****13

License Status

INACTIVE

Business

First Name

MICHELLE

Middle

Last Name

THACKER

Business Name

MICHELLE M THACKER

Original Issue Date

06/15/2018

Effective Date

05/16/2024

Expiration Date

05/31/2026

City

LAWRENCEVILLE

State

Zip

62439

County

LAWRENCE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/16/2024