NICOLE M WIEMAN Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****40

License Status

INACTIVE

Business

First Name

NICOLE

Middle

Last Name

WIEMAN

Business Name

NICOLE M WIEMAN

Original Issue Date

03/24/2014

Effective Date

10/01/2020

Expiration Date

08/31/2022

City

ROCKTON

State

Zip

61072

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/17/2022