SHANICE KUKUCK Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****40

License Status

ACTIVE

Business

First Name

SHANICE

Last Name

KUKUCK

Business Name

SHANICE KUKUCK

Original Issue Date

07/22/2025

Effective Date

07/22/2025

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026