AMANDA MICHELLE MAVIS Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****15

License Status

ACTIVE

Business

First Name

AMANDA

Middle

MICHELLE

Last Name

MAVIS

Business Name

AMANDA MICHELLE MAVIS

Original Issue Date

08/22/2017

Effective Date

04/30/2024

Expiration Date

05/31/2026

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026