THEODOR BROCKWAY Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209030467

License Status

ACTIVE

Business

First Name

THEODOR

Last Name

BROCKWAY

Business Name

THEODOR BROCKWAY

Original Issue Date

09/05/2024

Effective Date

09/05/2024

Expiration Date

05/31/2026

City

SHOREVIEW

State

Zip

55126

Ever Disciplined

LastModifiedDate

03/02/2026