KATHLEEN M MARTIN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****23

License Status

ACTIVE

Business

First Name

KATHLEEN

Middle

Last Name

MARTIN

Business Name

KATHLEEN M MARTIN

Original Issue Date

08/30/2002

Effective Date

04/12/2024

Expiration Date

05/31/2026

City

PRINCEVILLE

State

Zip

61559

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026