MALLORY RENEE WALTRIP Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209015762

License Status

ACTIVE

Business

First Name

MALLORY

Middle

RENEE

Last Name

WALTRIP

Business Name

MALLORY RENEE WALTRIP

Original Issue Date

03/14/2017

Effective Date

03/26/2026

Expiration Date

05/31/2028

City

ROCHESTER

State

Zip

62563

County

SANGAMON

Ever Disciplined

LastModifiedDate

03/26/2026