ANGELA M SIEBOLD Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****25

License Status

ACTIVE

Business

First Name

ANGELA

Middle

Last Name

SIEBOLD

Business Name

ANGELA M SIEBOLD

Original Issue Date

10/23/2020

Effective Date

04/15/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026