SARA MARIE GROTEFENDT Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****55

License Status

ACTIVE

Business

First Name

SARA

Middle

MARIE

Last Name

GROTEFENDT

Business Name

SARA MARIE GROTEFENDT

Original Issue Date

03/12/2019

Effective Date

05/08/2024

Expiration Date

05/31/2026

City

MARYVILLE

State

Zip

62062

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026