MADDIE R JOHNSON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****09

License Status

NOT RENEWED

Business

First Name

MADDIE

Middle

Last Name

JOHNSON

Business Name

MADDIE R JOHNSON

Original Issue Date

11/05/2019

Effective Date

11/05/2019

Expiration Date

09/30/2020

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/27/2022