AMY J FUGATE Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****16

License Status

NOT RENEWED

Business

First Name

AMY J

Last Name

FUGATE

Business Name

AMY J FUGATE

Original Issue Date

07/31/2020

Effective Date

07/31/2020

Expiration Date

08/31/2022

City

NEWTON

State

Zip

62448

County

JASPER

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022