SARA BETH NULL Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****58

License Status

NOT RENEWED

Business

First Name

SARA

Middle

BETH

Last Name

NULL

Business Name

SARA BETH NULL

Original Issue Date

09/18/2019

Effective Date

09/18/2019

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021