SHANNON MARIE KUSSATZ Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****17

License Status

INOPERATIVE

Business

First Name

SHANNON

Middle

MARIE

Last Name

KUSSATZ

Business Name

SHANNON MARIE KUSSATZ

Original Issue Date

03/11/2016

Effective Date

03/11/2016

Expiration Date

05/31/2018

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

03/01/2018