HOLLY A CLARK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****90

License Status

NOT RENEWED

Business

First Name

HOLLY A

Last Name

CLARK

Business Name

HOLLY A CLARK

Original Issue Date

06/19/2001

Effective Date

06/19/2001

Expiration Date

05/31/2004

City

WORTH

State

Zip

60482

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006