ZACHARY TAYLOR BACKLIN Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****18

License Status

INACTIVE

Business

First Name

ZACHARY

Middle

TAYLOR

Last Name

BACKLIN

Business Name

ZACHARY TAYLOR BACKLIN

Original Issue Date

03/05/2020

Effective Date

03/05/2020

Expiration Date

05/31/2022

City

MATTOON

State

Zip

61938

Ever Disciplined

LastModifiedDate

03/05/2020