DANIEL T FOUTCH Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****41

License Status

INACTIVE

Business

First Name

DANIEL

Middle

Last Name

FOUTCH

Business Name

DANIEL T FOUTCH

Original Issue Date

10/14/2021

Effective Date

05/06/2022

Expiration Date

06/30/2024

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/07/2024