BETHANY A LONGTIN Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****75

License Status

INOPERATIVE

Business

First Name

BETHANY

Middle

Last Name

LONGTIN

Business Name

BETHANY A LONGTIN

Original Issue Date

10/05/2011

Effective Date

03/22/2016

Expiration Date

05/31/2018

City

GILBERTS

State

Zip

60136

County

COOK

Ever Disciplined

LastModifiedDate

03/01/2018