MELISSA THIBAULT MIKOTA 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

MELISSA

Middle

THIBAULT

Last Name

MIKOTA

Business Name

MELISSA THIBAULT MIKOTA

Original Issue Date

03/08/2026

Effective Date

03/08/2026

Expiration Date

05/31/2028

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/08/2026