MARY BRANDENBURG Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****15

License Status

NOT RENEWED

Business

First Name

MARY

Last Name

BRANDENBURG

Business Name

MARY BRANDENBURG

Original Issue Date

02/02/2021

Effective Date

06/02/2022

Expiration Date

06/30/2024

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025