JACQUELINE M DEFFENBAUGH Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****70

License Status

INACTIVE

Business

First Name

JACQUELINE

Middle

Last Name

DEFFENBAUGH

Business Name

JACQUELINE M DEFFENBAUGH

Original Issue Date

07/19/2001

Effective Date

04/12/2018

Expiration Date

09/30/2020

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

04/30/2020