SUZANNE D TIETJEN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****41

License Status

NOT RENEWED

Business

First Name

SUZANNE D

Last Name

TIETJEN

Business Name

SUZANNE D TIETJEN

Original Issue Date

03/20/2008

Effective Date

05/06/2010

Expiration Date

05/31/2012

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

07/10/2012