TERRYL ANN POLANIN Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****77

License Status

INACTIVE

Business

First Name

TERRYL

Middle

ANN

Last Name

POLANIN

Business Name

TERRYL ANN POLANIN

Original Issue Date

06/19/2001

Effective Date

03/13/2018

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

03/12/2018