BRIAN T MULDER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****06

License Status

ACTIVE

Business

First Name

BRIAN

Middle

Last Name

MULDER

Business Name

BRIAN T MULDER

Original Issue Date

01/08/2014

Effective Date

04/17/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026