MARLA JO VANVICKLE Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****20

License Status

INACTIVE

Business

First Name

MARLA

Middle

Last Name

VANVICKLE

Business Name

MARLA JO VANVICKLE

Original Issue Date

06/17/2021

Effective Date

04/26/2024

Expiration Date

05/31/2026

City

OREGON

State

Zip

61061

County

OGLE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/05/2025