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*****45

License Status

INACTIVE

Business

First Name

DANIEL

Middle

Last Name

FOUTCH

Business Name

DANIEL T FOUTCH

Original Issue Date

04/23/2022

Effective Date

05/06/2024

Expiration Date

05/31/2026

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/07/2024