MACKENZIE ROCHON CLARK-SELTZNER 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

MACKENZIE

Middle

ROCHON

Last Name

CLARK-SELTZNER

Business Name

MACKENZIE ROCHON CLARK-SELTZNER

Original Issue Date

04/06/2019

Effective Date

04/06/2019

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61107

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021