JOSE G MANTILLA-ACEVEDO Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****47

License Status

NOT RENEWED

Business

First Name

JOSE

Middle

Last Name

MANTILLA-ACEVEDO

Business Name

JOSE G MANTILLA-ACEVEDO

Original Issue Date

02/28/2012

Effective Date

05/06/2012

Expiration Date

05/31/2014

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/03/2014