PUNAM TRIVEDE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****04

License Status

ACTIVE

Business

First Name

PUNAM

Last Name

TRIVEDE

Business Name

PUNAM TRIVEDE

Original Issue Date

03/07/2019

Effective Date

04/22/2024

Expiration Date

05/31/2026

City

LINCOLN

State

Zip

62526

County

LOGAN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026