SUSAN FAIRLEY-HOLBACH Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****67

License Status

NOT RENEWED

Business

First Name

SUSAN

Last Name

FAIRLEY-HOLBACH

Business Name

SUSAN FAIRLEY-HOLBACH

Original Issue Date

09/05/2014

Effective Date

09/05/2014

Expiration Date

05/31/2016

City

WAUKEGAN

State

Zip

60085

County

LAKE

Ever Disciplined

LastModifiedDate

07/11/2016