TARA MARIE SHUTT 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

TARA

Middle

MARIE

Last Name

SHUTT

Business Name

TARA MARIE SHUTT

Original Issue Date

05/03/2019

Effective Date

04/20/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/02/2026