ANDREA KAY MEHLBAUM Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****21

License Status

ACTIVE

Business

First Name

ANDREA

Middle

KAY

Last Name

MEHLBAUM

Business Name

ANDREA KAY MEHLBAUM

Original Issue Date

07/11/2017

Effective Date

04/02/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

03/02/2026