DIANE C WILDRICK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****96

License Status

NOT RENEWED

Business

First Name

DIANE C

Last Name

WILDRICK

Business Name

DIANE C WILDRICK

Original Issue Date

01/29/2002

Effective Date

05/11/2020

Expiration Date

08/31/2022

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022