HEATHER E RUTHSTROM Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****76

License Status

ACTIVE

Business

First Name

HEATHER

Middle

Last Name

RUTHSTROM

Business Name

HEATHER E RUTHSTROM

Original Issue Date

03/13/2019

Effective Date

04/30/2024

Expiration Date

05/31/2026

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026