KATY JO NORTHCUTT 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

KATY

Middle

Last Name

NORTHCUTT

Business Name

KATY JO NORTHCUTT

Original Issue Date

04/28/2020

Effective Date

04/28/2020

Expiration Date

08/31/2022

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022