ANGELA GRAY 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

ANGELA

Last Name

GRAY

Business Name

ANGELA GRAY

BusinessDBA

SHANK

Original Issue Date

04/01/2023

Effective Date

03/09/2026

Expiration Date

05/31/2028

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/09/2026