JENNA L DIVELY Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****00

License Status

ACTIVE

Business

First Name

JENNA

Middle

Last Name

DIVELY

Business Name

JENNA L DIVELY

Original Issue Date

12/15/2025

Effective Date

12/15/2025

Expiration Date

05/31/2026

City

CANTON

State

Zip

61520

County

FULTON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026