TANNER E LACK Registered Nurse License verification

Business Entity

ACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041591825

License Status

ACTIVE

Business

First Name

TANNER

Middle

Last Name

LACK

Business Name

TANNER E LACK

Original Issue Date

07/30/2025

Effective Date

07/30/2025

Expiration Date

05/31/2026

City

CHAMPAIGN

State

Zip

61821

Ever Disciplined

LastModifiedDate

03/01/2026