ELIZABETH FERN GEPHART Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****77

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

FERN

Last Name

GEPHART

Business Name

ELIZABETH FERN GEPHART

Original Issue Date

05/25/2001

Effective Date

04/12/2018

Expiration Date

09/30/2020

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

01/14/2021