MATTHEW JOSEPH WILLIS 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

MATTHEW

Middle

JOSEPH

Last Name

WILLIS

Business Name

MATTHEW JOSEPH WILLIS

Original Issue Date

04/01/2020

Effective Date

04/02/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61606

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026