O. DENISE RUNESTAD Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****29

License Status

ACTIVE

Business

First Name

Middle

DENISE

Last Name

RUNESTAD

Business Name

O. DENISE RUNESTAD

Original Issue Date

05/10/2023

Effective Date

03/11/2026

Expiration Date

05/31/2028

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/11/2026