CHANTELLE E PETERSON 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

CHANTELLE

Middle

Last Name

PETERSON

Business Name

CHANTELLE E PETERSON

Original Issue Date

01/30/2018

Effective Date

05/21/2018

Expiration Date

09/30/2020

City

ALEDO

State

Zip

61231

County

MERCER

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021