KELLY CRAIN CLARK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209008033

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

CRAIN

Last Name

CLARK

Business Name

KELLY CRAIN CLARK

Original Issue Date

02/09/2010

Effective Date

08/18/2010

Expiration Date

05/31/2012

City

RACINE

State

Zip

53402

County

WISCONSIN

Ever Disciplined

LastModifiedDate

07/10/2012