AMANDA M BUSTLE Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****13

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

BUSTLE

Business Name

AMANDA M BUSTLE

Original Issue Date

03/08/2017

Effective Date

05/21/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021