MIRIAM EDITH KECLIK 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

MIRIAM

Middle

EDITH

Last Name

KECLIK

Business Name

MIRIAM EDITH KECLIK

Original Issue Date

05/01/2023

Effective Date

03/19/2026

Expiration Date

05/31/2028

City

MCHENRY

State

Zip

60050

County

MCHENRY

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/19/2026