KELLY SUE RASMUSSEN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****50

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

SUE

Last Name

RASMUSSEN

Business Name

KELLY SUE RASMUSSEN

Original Issue Date

07/25/2017

Effective Date

04/17/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021