PHILIP S DUDAK Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****56

License Status

INOPERATIVE

Business

First Name

PHILIP S

Last Name

DUDAK

Business Name

PHILIP S DUDAK

Original Issue Date

10/02/2013

Effective Date

02/10/2017

Expiration Date

05/31/2018

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

03/01/2018