DERRICK T PREVATT Advanced Practice Nurse License verification

Business Entity

INOPERATIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****79

License Status

INOPERATIVE

Business

First Name

DERRICK

Middle

Last Name

PREVATT

Business Name

DERRICK T PREVATT

Original Issue Date

11/21/2014

Effective Date

11/21/2014

Expiration Date

05/31/2016

City

ROBINSON

State

Zip

62454

County

CRAWFORD

Ever Disciplined

LastModifiedDate

11/21/2014