TRACIE E FOSTER Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****19

License Status

NOT RENEWED

Business

First Name

TRACIE

Middle

Last Name

FOSTER

Business Name

TRACIE E FOSTER

Original Issue Date

06/05/2015

Effective Date

05/04/2022

Expiration Date

06/30/2024

City

CENTRALIA

State

Zip

62801

County

MARION

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025