TABITHA NICOLE MARIS Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****48

License Status

NOT RENEWED

Business

First Name

TABITHA

Middle

NICOLE

Last Name

MARIS

Business Name

TABITHA NICOLE MARIS

Original Issue Date

06/05/2002

Effective Date

06/05/2002

Expiration Date

05/31/2006

City

MOUNT CARMEL

State

Zip

62863

County

WABASH

Ever Disciplined

LastModifiedDate

10/09/2006