BRADLEY WAYNE GRISSOM Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209005691

License Status

ACTIVE

Business

First Name

BRADLEY

Middle

WAYNE

Last Name

GRISSOM

Business Name

BRADLEY WAYNE GRISSOM

Original Issue Date

09/01/2005

Effective Date

04/25/2024

Expiration Date

05/31/2026

City

BISMARCK

State

Zip

61814

County

VERMILION

Ever Disciplined

LastModifiedDate

03/02/2026