TRACY L DYSARD Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****73

License Status

NOT RENEWED

Business

First Name

TRACY

Middle

Last Name

DYSARD

Business Name

TRACY L DYSARD

Original Issue Date

07/19/2001

Effective Date

05/07/2020

Expiration Date

08/31/2022

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022