TIMOTHY EDWARD HAZARD Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****13

License Status

INOPERATIVE

Business

First Name

TIMOTHY

Middle

EDWARD

Last Name

HAZARD

Business Name

TIMOTHY EDWARD HAZARD

Original Issue Date

10/20/2011

Effective Date

04/17/2018

Expiration Date

09/30/2020

City

MOKENA

State

Zip

60448

County

WILL

Ever Disciplined

LastModifiedDate

03/08/2020