JERI A LAKE Advanced Practice Nurse License verification

Business Entity

CANCELLED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****57

License Status

CANCELLED

Business

First Name

JERI A

Last Name

LAKE

Business Name

JERI A LAKE

Original Issue Date

08/01/2001

Effective Date

08/01/2001

Expiration Date

05/31/2006

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/28/2006