NICOLE MARIE PAHL Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****25

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

MARIE

Last Name

PAHL

Business Name

NICOLE MARIE PAHL

Original Issue Date

09/21/2017

Effective Date

04/12/2018

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61614

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021