MELISSA M THEOBALD Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209030474

License Status

ACTIVE

Business

First Name

MELISSA

Middle

Last Name

THEOBALD

Business Name

MELISSA M THEOBALD

Original Issue Date

09/06/2024

Effective Date

09/06/2024

Expiration Date

05/31/2026

City

PRINCEVILLE

State

Zip

61559

County

PEORIA

Ever Disciplined

LastModifiedDate

03/02/2026