SAMANTHA A BANEY Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****48

License Status

INACTIVE

Business

First Name

SAMANTHA

Middle

Last Name

BANEY

Business Name

SAMANTHA A BANEY

Original Issue Date

08/15/2019

Effective Date

07/06/2022

Expiration Date

05/31/2024

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/06/2022