TARA ROSE DERRY Respiratory Care Practitioner License verification

Business Entity

ACTIVE

License Type

Respiratory Care Practitioner

Description

RESPIRATORY CARE PRACTITIONER

License Number

194011768

License Status

ACTIVE

Business

First Name

TARA

Middle

ROSE

Last Name

DERRY

Business Name

TARA ROSE DERRY

Original Issue Date

07/21/2021

Effective Date

10/25/2025

Expiration Date

10/31/2027

City

PRINCEVILLE

State

Zip

61559

County

PEORIA

Ever Disciplined

LastModifiedDate

10/25/2025