AMANDA S PUMILIA Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****24

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

PUMILIA

Business Name

AMANDA S PUMILIA

Original Issue Date

10/13/2016

Effective Date

04/10/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021