MARY KATHLEEN LAIRD 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

MARY

Middle

KATHLEEN

Last Name

LAIRD

Business Name

MARY KATHLEEN LAIRD

Original Issue Date

07/09/2021

Effective Date

07/09/2021

Expiration Date

08/31/2022

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Delegated Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/14/2022