ANGELA D JOHNSON Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****03

License Status

INACTIVE

Business

First Name

ANGELA

Middle

Last Name

JOHNSON

Business Name

ANGELA D JOHNSON

Original Issue Date

03/10/2016

Effective Date

03/22/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/21/2018