MICHELLE R FULLER Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****40

License Status

INACTIVE

Business

First Name

MICHELLE

Middle

Last Name

FULLER

Business Name

MICHELLE R FULLER

Original Issue Date

08/19/2015

Effective Date

06/22/2022

Expiration Date

05/31/2024

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

06/22/2022