LISA LAUREN ANTLE Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****80

License Status

NOT RENEWED

Business

First Name

LISA

Middle

LAUREN

Last Name

ANTLE

Business Name

LISA LAUREN ANTLE

Original Issue Date

10/27/2017

Effective Date

06/02/2020

Expiration Date

08/31/2022

City

DELAVAN

State

Zip

53115

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2022