LISA A LARSON 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

LISA

Middle

Last Name

LARSON

Business Name

LISA A LARSON

Original Issue Date

08/01/2001

Effective Date

05/20/2020

Expiration Date

05/31/2022

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/20/2020