MARY T DAMBACHER Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****42

License Status

ACTIVE

Business

First Name

MARY

Middle

Last Name

DAMBACHER

Business Name

MARY T DAMBACHER

Original Issue Date

09/27/2013

Effective Date

03/04/2026

Expiration Date

05/31/2028

City

DIVERNON

State

Zip

62530

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/04/2026