SULLIVAN WASKOSKY 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

SULLIVAN

Last Name

WASKOSKY

Business Name

SULLIVAN WASKOSKY

Original Issue Date

07/16/2025

Effective Date

03/11/2026

Expiration Date

05/31/2028

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/11/2026