REBECCA A BRENNEISEN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****16

License Status

ACTIVE

Business

First Name

REBECCA

Middle

Last Name

BRENNEISEN

Prefix

Business Name

REBECCA A BRENNEISEN

Original Issue Date

08/28/2021

Effective Date

03/03/2024

Expiration Date

05/31/2026

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026