BENJAMIN WINDHAM 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

BENJAMIN

Last Name

WINDHAM

Business Name

BENJAMIN WINDHAM

Original Issue Date

05/22/2025

Effective Date

03/04/2026

Expiration Date

05/31/2028

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/04/2026