MARCUS MUTIDJO Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209016806

License Status

ACTIVE

Business

First Name

MARCUS

Last Name

MUTIDJO

Business Name

MARCUS MUTIDJO

Original Issue Date

10/25/2017

Effective Date

04/21/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61603

Ever Disciplined

LastModifiedDate

03/02/2026