KELLY MARIE WHITAKER Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****65

License Status

INACTIVE

Business

First Name

KELLY

Middle

MARIE

Last Name

WHITAKER

Business Name

KELLY MARIE WHITAKER

Original Issue Date

10/03/2011

Effective Date

03/08/2020

Expiration Date

05/31/2022

City

MASCOUTAH

State

Zip

62258

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

04/20/2020