TIFFANY K HENDRICKS Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****93

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

Last Name

HENDRICKS

Business Name

TIFFANY K HENDRICKS

Original Issue Date

12/23/2019

Effective Date

05/21/2020

Expiration Date

08/31/2022

City

GALESBURG

State

Zip

61401

County

KNOX

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022