NICHOLE BROCKMEYER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****11

License Status

ACTIVE

Business

First Name

NICHOLE

Last Name

BROCKMEYER

Business Name

NICHOLE BROCKMEYER

Original Issue Date

07/06/2017

Effective Date

05/05/2024

Expiration Date

05/31/2026

City

SHERMAN

State

Zip

62684

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026