SUSAN SAMANATHA MCCORMICK 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

SUSAN

Middle

SAMANATHA

Last Name

MCCORMICK

Business Name

SUSAN SAMANATHA MCCORMICK

Original Issue Date

04/18/2002

Effective Date

04/18/2002

Expiration Date

05/31/2004

City

PERU

State

Zip

61354

County

LA SALLE

Ever Disciplined

LastModifiedDate

10/09/2006