NATHALIE KAE DIETHRICH Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****47

License Status

INACTIVE

Business

First Name

NATHALIE

Middle

KAE

Last Name

DIETHRICH

Business Name

NATHALIE KAE DIETHRICH

Original Issue Date

11/07/2016

Effective Date

04/21/2020

Expiration Date

05/31/2022

City

DECATUR

State

Zip

62523

Ever Disciplined

LastModifiedDate

04/21/2020