EVAN WALDER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****17

License Status

ACTIVE

Business

First Name

EVAN

Last Name

WALDER

Business Name

EVAN WALDER

Original Issue Date

11/14/2024

Effective Date

11/14/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/02/2026