TARA LYNN LIVINGSTON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****91

License Status

NOT RENEWED

Business

First Name

TARA

Middle

LYNN

Last Name

LIVINGSTON

Business Name

TARA LYNN LIVINGSTON

Original Issue Date

08/06/2019

Effective Date

08/06/2019

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61614

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021