DIANE Y SMITH Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****54

License Status

INOPERATIVE

Business

First Name

DIANE

Middle

Last Name

SMITH

Business Name

DIANE Y SMITH

Original Issue Date

06/11/2002

Effective Date

06/25/2024

Expiration Date

05/31/2026

City

LANSING

State

Zip

60438

County

WILL

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/25/2024