KRYSTAL HEGGESTAD Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****30

License Status

NOT RENEWED

Business

First Name

KRYSTAL

Last Name

HEGGESTAD

Business Name

KRYSTAL HEGGESTAD

Original Issue Date

08/12/2019

Effective Date

03/08/2020

Expiration Date

08/31/2022

City

PEORIA

State

Zip

61614

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022