DORY A MICKNA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****05

License Status

ACTIVE

Business

First Name

DORY

Middle

Last Name

MICKNA

Business Name

DORY A MICKNA

Original Issue Date

02/03/2026

Effective Date

02/03/2026

Expiration Date

05/31/2026

City

TREMONT

State

Zip

61568

County

LIVINGSTON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026