MARY L TISDALE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****52

License Status

ACTIVE

Business

First Name

MARY

Middle

Last Name

TISDALE

Business Name

MARY L TISDALE

Original Issue Date

02/04/2010

Effective Date

04/20/2024

Expiration Date

05/31/2026

City

PEORIA

State

Zip

61606

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026