LISA A BOURQUIN Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****88

License Status

INACTIVE

Business

First Name

LISA

Middle

Last Name

BOURQUIN

Business Name

LISA A BOURQUIN

Original Issue Date

01/26/2024

Effective Date

05/13/2024

Expiration Date

05/31/2026

City

GALENA

State

Zip

61036

County

JO DAVIESS

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/13/2024