ROGER DWAYNE SHOCKEY Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****37

License Status

NOT RENEWED

Business

First Name

ROGER

Middle

DWAYNE

Last Name

SHOCKEY

Business Name

ROGER DWAYNE SHOCKEY

Original Issue Date

12/09/2022

Effective Date

12/09/2022

Expiration Date

06/30/2024

City

NORMAL

State

Zip

61761

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025