LANCE RAYMOND FREDRICKSON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209007323

License Status

NOT RENEWED

Business

First Name

LANCE

Middle

RAYMOND

Last Name

FREDRICKSON

Business Name

LANCE RAYMOND FREDRICKSON

Original Issue Date

10/28/2008

Effective Date

10/28/2008

Expiration Date

05/31/2010

City

COLUMBIA

State

Zip

65201

County

MISSOURI

Ever Disciplined

LastModifiedDate

08/11/2010