DEBRA D MANGRUM Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****48

License Status

ACTIVE

Business

First Name

DEBRA D

Last Name

MANGRUM

Business Name

DEBRA D MANGRUM

Original Issue Date

03/15/2017

Effective Date

04/09/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60616

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026