KATHY L DERRICK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****77

License Status

ACTIVE

Business

First Name

KATHY

Middle

Last Name

DERRICK

Business Name

KATHY L DERRICK

Original Issue Date

07/28/2014

Effective Date

03/03/2026

Expiration Date

05/31/2028

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/03/2026