JOSE G MANTILLA-ACEVEDO Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209008328

License Status

NOT RENEWED

Business

First Name

JOSE

Middle

Last Name

MANTILLA-ACEVEDO

Business Name

JOSE G MANTILLA-ACEVEDO

Original Issue Date

08/31/2010

Effective Date

03/19/2014

Expiration Date

05/31/2016

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/11/2016