DANIEL R GREEN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****07

License Status

ACTIVE

Business

First Name

DANIEL

Middle

Last Name

GREEN

Business Name

DANIEL R GREEN

Original Issue Date

08/22/2016

Effective Date

04/22/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026