KERRY M DETWEILER Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****75

License Status

NOT RENEWED

Business

First Name

KERRY

Middle

Last Name

DETWEILER

Business Name

KERRY M DETWEILER

Original Issue Date

02/27/2018

Effective Date

05/06/2018

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61606

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021