GINA M FERNANDO Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****15

License Status

INACTIVE

Business

First Name

GINA

Middle

Last Name

FERNANDO

Business Name

GINA M FERNANDO

Original Issue Date

07/01/2020

Effective Date

04/15/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/19/2025