CRYSTAL SUE CLARK Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****64

License Status

INACTIVE

Business

First Name

CRYSTAL

Middle

SUE

Last Name

CLARK

Business Name

CRYSTAL SUE CLARK

Original Issue Date

05/08/2018

Effective Date

09/02/2020

Expiration Date

05/31/2022

City

MONTICELLO

State

Zip

61856

County

PIATT

Ever Disciplined

LastModifiedDate

05/27/2020