MIRANDA JANE KENNEDY Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****45

License Status

NOT RENEWED

Business

First Name

MIRANDA

Middle

JANE

Last Name

KENNEDY

Business Name

MIRANDA JANE KENNEDY

Original Issue Date

03/29/2016

Effective Date

05/03/2022

Expiration Date

06/30/2024

City

EDWARDS

State

Zip

61528

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025