ALLECIA LYNN THIBEAULT Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****46

License Status

NOT RENEWED

Business

First Name

ALLECIA

Middle

LYNN

Last Name

THIBEAULT

Business Name

ALLECIA LYNN THIBEAULT

Original Issue Date

08/20/2015

Effective Date

05/02/2018

Expiration Date

09/30/2020

City

DUNLAP

State

Zip

61525

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021