MITZIE RALPH FAIRFIELD Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****15

License Status

ACTIVE

Business

First Name

MITZIE RALPH

Last Name

FAIRFIELD

Business Name

MITZIE RALPH FAIRFIELD

Original Issue Date

09/19/2001

Effective Date

03/23/2024

Expiration Date

05/31/2026

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

03/02/2026