MIRAGENE BROSSEAU 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

MIRAGENE

Last Name

BROSSEAU

Business Name

MIRAGENE BROSSEAU

Original Issue Date

03/26/2007

Effective Date

05/16/2022

Expiration Date

06/30/2024

City

BOURBONNAIS

State

Zip

60914

County

IROQUOIS

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025