MARY ELIZABETH GOLEMBECK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****44

License Status

NOT RENEWED

Business

First Name

MARY

Middle

ELIZABETH

Last Name

GOLEMBECK

Business Name

MARY ELIZABETH GOLEMBECK

Original Issue Date

08/24/2017

Effective Date

05/23/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021