KELLY M BANASKY Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****65

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

BANASKY

Business Name

KELLY M BANASKY

Original Issue Date

10/08/2015

Effective Date

10/08/2015

Expiration Date

05/31/2016

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

07/11/2016