HEIDI A WAGNER 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

HEIDI A

Last Name

WAGNER

Business Name

HEIDI A WAGNER

Original Issue Date

09/07/2018

Effective Date

03/10/2024

Expiration Date

05/31/2026

City

BOLINGBROOK

State

Zip

60440

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026