NICOLE A BENNETT Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****34

License Status

ACTIVE

Business

First Name

NICOLE

Middle

Last Name

BENNETT

Business Name

NICOLE A BENNETT

Original Issue Date

09/20/2024

Effective Date

09/20/2024

Expiration Date

05/31/2026

City

EAST ALTON

State

Zip

62024

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026