GENTI MANCO Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****08

License Status

ACTIVE

Business

First Name

GENTI

Last Name

MANCO

Business Name

GENTI MANCO

Original Issue Date

10/28/2016

Effective Date

05/22/2024

Expiration Date

05/31/2026

City

WOOD RIVER

State

Zip

62095

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026