MARY ELAINE EIDENT 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

MARY

Middle

ELAINE

Last Name

EIDENT

Business Name

MARY ELAINE EIDENT

Original Issue Date

01/12/2021

Effective Date

05/07/2022

Expiration Date

06/30/2024

City

DANVILLE

State

Zip

61832

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025