PENELOPE A SHIELDS Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****23

License Status

INACTIVE

Business

First Name

PENELOPE

Middle

Last Name

SHIELDS

Business Name

PENELOPE A SHIELDS

Original Issue Date

02/11/2015

Effective Date

04/03/2024

Expiration Date

05/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/09/2025