ERA L MATTINGLY Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****01

License Status

ACTIVE

Business

First Name

ERA L

Last Name

MATTINGLY

Business Name

ERA L MATTINGLY

Original Issue Date

12/26/2019

Effective Date

05/30/2024

Expiration Date

05/31/2026

City

CENTRALIA

State

Zip

62801

County

MARION

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026