DIANE L DESTEFANO Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****56

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

Last Name

DESTEFANO

Business Name

DIANE L DESTEFANO

Original Issue Date

09/27/2012

Effective Date

09/27/2012

Expiration Date

05/31/2014

City

GRAYVILLE

State

Zip

62844

County

WHITE

Ever Disciplined

LastModifiedDate

07/03/2014