JESSICA ANNE WALLIS-BHYRAVABOTLA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****27

License Status

ACTIVE

Business

First Name

JESSICA

Middle

ANNE

Last Name

WALLIS-BHYRAVABOTLA

Business Name

JESSICA ANNE WALLIS-BHYRAVABOTLA

Original Issue Date

08/31/2015

Effective Date

03/17/2026

Expiration Date

05/31/2028

City

PEORIA

State

Zip

61605

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/17/2026