SHANNON D WALLER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209013915

License Status

ACTIVE

Business

First Name

SHANNON

Middle

Last Name

WALLER

Business Name

SHANNON D WALLER

Original Issue Date

02/29/2016

Effective Date

05/24/2024

Expiration Date

05/31/2026

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Ever Disciplined

LastModifiedDate

03/02/2026