ERICA NICOLE SACK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****15

License Status

NOT RENEWED

Business

First Name

ERICA

Middle

NICOLE

Last Name

SACK

Business Name

ERICA NICOLE SACK

Original Issue Date

10/05/2021

Effective Date

10/05/2021

Expiration Date

08/31/2022

City

EAST MOLINE

State

Zip

61244

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022