KIRSTEN DIANE CLERKIN Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****81

License Status

INACTIVE

Business

First Name

KIRSTEN

Middle

DIANE

Last Name

CLERKIN

Business Name

KIRSTEN DIANE CLERKIN

Original Issue Date

10/11/2013

Effective Date

07/06/2022

Expiration Date

05/31/2024

City

BLOOMINGTON

State

Zip

61704

County

MCDONOUGH

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/03/2024