JACKI LEA WILDEMAN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****50

License Status

NOT RENEWED

Business

First Name

JACKI

Middle

LEA

Last Name

WILDEMAN

Business Name

JACKI LEA WILDEMAN

Original Issue Date

11/21/2003

Effective Date

05/01/2018

Expiration Date

09/30/2020

City

NEWBURGH

State

Zip

47630

County

INDIANA

Ever Disciplined

LastModifiedDate

01/14/2021