EDWARD E ETHERTON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****87

License Status

NOT RENEWED

Business

First Name

EDWARD

Middle

Last Name

ETHERTON

Business Name

EDWARD E ETHERTON

Original Issue Date

10/05/2012

Effective Date

06/23/2020

Expiration Date

08/31/2022

City

DUNLAP

State

Zip

61525

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022