MARY SAMULEVICH Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****38

License Status

ACTIVE

Business

First Name

MARY

Last Name

SAMULEVICH

Business Name

MARY SAMULEVICH

Original Issue Date

01/14/2021

Effective Date

03/02/2026

Expiration Date

05/31/2028

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026