ANGELITO D TACDERAS Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****47

License Status

NOT RENEWED

Business

First Name

ANGELITO D

Last Name

TACDERAS

Business Name

ANGELITO D TACDERAS

Original Issue Date

02/02/2010

Effective Date

04/20/2018

Expiration Date

09/30/2020

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021