ROSS D HERDES Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****43

License Status

INACTIVE

Business

First Name

ROSS

Middle

Last Name

HERDES

Business Name

ROSS D HERDES

Original Issue Date

02/27/2019

Effective Date

05/14/2024

Expiration Date

05/31/2026

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2024