ANN MARIE SELF NP Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****35

License Status

NOT RENEWED

Business

Title

First Name

ANN

Middle

MARIE

Last Name

SELF

Business Name

ANN MARIE SELF NP

Original Issue Date

09/18/2007

Effective Date

06/11/2022

Expiration Date

06/30/2024

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025