JILL LOUISE WAGENBACH Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209030316

License Status

ACTIVE

Business

First Name

JILL

Middle

LOUISE

Last Name

WAGENBACH

Business Name

JILL LOUISE WAGENBACH

BusinessDBA

JILL WAGENBACH

Original Issue Date

08/19/2024

Effective Date

08/19/2024

Expiration Date

05/31/2026

City

TREMONT

State

Zip

61568

County

TAZEWELL

Ever Disciplined

LastModifiedDate

03/02/2026