SARA DEBROCK 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

SARA

Last Name

DEBROCK

Business Name

SARA DEBROCK

Original Issue Date

03/04/2022

Effective Date

03/04/2022

Expiration Date

06/30/2024

City

ROCKFORD

State

Zip

61112

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025