TARA L JOHNSON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****53

License Status

NOT RENEWED

Business

First Name

TARA

Middle

Last Name

JOHNSON

Business Name

TARA L JOHNSON

Original Issue Date

11/05/2018

Effective Date

07/28/2022

Expiration Date

06/30/2024

City

MOLINE

State

Zip

61265

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025