FARRELL GODBOUT Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****20

License Status

NOT RENEWED

Business

First Name

FARRELL

Last Name

GODBOUT

Business Name

FARRELL GODBOUT

Original Issue Date

03/20/2013

Effective Date

04/19/2018

Expiration Date

09/30/2020

City

HINSDALE

State

Zip

60521

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021