LEA L CLARK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****17

License Status

ACTIVE

Business

First Name

LEA

Middle

Last Name

CLARK

Business Name

LEA L CLARK

Original Issue Date

08/06/2021

Effective Date

03/14/2024

Expiration Date

05/31/2026

City

GALESBURG

State

Zip

61401

County

KNOX

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026