SHAWNA LEE STORM Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****12

License Status

ACTIVE

Business

First Name

SHAWNA

Middle

LEE

Last Name

STORM

Business Name

SHAWNA LEE STORM

Original Issue Date

09/25/2019

Effective Date

03/03/2026

Expiration Date

05/31/2028

City

VILLA GROVE

State

Zip

61956

County

DOUGLAS

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/03/2026