TINA L LONGPHEE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****44

License Status

ACTIVE

Business

First Name

TINA

Middle

Last Name

LONGPHEE

Business Name

TINA L LONGPHEE

Original Issue Date

01/08/2020

Effective Date

05/08/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026