KIMBERLY A WAGENAAR Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****97

License Status

NOT RENEWED

Business

First Name

KIMBERLY

Middle

Last Name

WAGENAAR

Business Name

KIMBERLY A WAGENAAR

Original Issue Date

08/01/2001

Effective Date

04/22/2012

Expiration Date

05/31/2014

City

WAUKEGAN

State

Zip

60085

County

LAKE

Ever Disciplined

LastModifiedDate

07/03/2014