BRITTANY J PENA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****11

License Status

NOT RENEWED

Business

First Name

BRITTANY

Middle

Last Name

PENA

Business Name

BRITTANY J PENA

Original Issue Date

10/28/2016

Effective Date

05/28/2020

Expiration Date

08/31/2022

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/14/2022