JENNIFER L SMIDT Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****55

License Status

INACTIVE

Business

First Name

JENNIFER

Middle

Last Name

SMIDT

Business Name

JENNIFER L SMIDT

Original Issue Date

05/19/2014

Effective Date

03/20/2020

Expiration Date

05/31/2022

City

PEORIA

State

Zip

61602

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/20/2020