LISSA J DIEFENDORF Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****71

License Status

ACTIVE

Business

First Name

LISSA J

Last Name

DIEFENDORF

Business Name

LISSA J DIEFENDORF

Original Issue Date

05/26/2010

Effective Date

05/06/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61604

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026