LACRETIA MANA DANIELS Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****88

License Status

NOT RENEWED

Business

First Name

LACRETIA

Middle

MANA

Last Name

DANIELS

Business Name

LACRETIA MANA DANIELS

Original Issue Date

09/22/2009

Effective Date

05/04/2018

Expiration Date

09/30/2020

City

SAINT CHARLES

State

Zip

63304

County

MADISON

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021