CARISSA R GORHAM Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****21

License Status

INACTIVE

Business

First Name

CARISSA

Middle

Last Name

GORHAM

Business Name

CARISSA R GORHAM

Original Issue Date

12/31/2014

Effective Date

04/03/2018

Expiration Date

09/30/2020

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

03/08/2020