STEPHANIE ROSE WYNN Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****04

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

ROSE

Last Name

WYNN

Business Name

STEPHANIE ROSE WYNN

Original Issue Date

09/25/2019

Effective Date

09/25/2019

Expiration Date

09/30/2020

City

KENOSHA

State

Zip

53143

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021