LEAH M GRAVESEN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****13

License Status

ACTIVE

Business

First Name

LEAH

Middle

Last Name

GRAVESEN

Business Name

LEAH M GRAVESEN

Original Issue Date

01/08/2022

Effective Date

03/04/2026

Expiration Date

05/31/2028

City

PONTIAC

State

Zip

61764

County

LIVINGSTON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/04/2026