PATRICIA M THAKER Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****28

License Status

NOT RENEWED

Business

First Name

PATRICIA

Middle

Last Name

THAKER

Business Name

PATRICIA M THAKER

Original Issue Date

04/05/2017

Effective Date

04/26/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021