LUCY WALTERS MARTIN Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****57

License Status

ACTIVE

Business

First Name

LUCY WALTERS

Last Name

MARTIN

Business Name

LUCY WALTERS MARTIN

Original Issue Date

02/04/2002

Effective Date

03/04/2026

Expiration Date

05/31/2028

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/04/2026