SUSAN KATHRYN MATHIS Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****49

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

KATHRYN

Last Name

MATHIS

Business Name

SUSAN KATHRYN MATHIS

Original Issue Date

02/25/2014

Effective Date

02/25/2014

Expiration Date

05/31/2014

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/03/2014