CANDICE J HOLDER Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****64

License Status

NOT RENEWED

Business

First Name

CANDICE

Middle

Last Name

HOLDER

Business Name

CANDICE J HOLDER

Original Issue Date

08/20/2019

Effective Date

08/20/2019

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021