ANGELA M LONGEVILLE Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****58

License Status

ACTIVE

Business

First Name

ANGELA

Middle

Last Name

LONGEVILLE

Business Name

ANGELA M LONGEVILLE

Original Issue Date

03/04/2019

Effective Date

05/07/2024

Expiration Date

05/31/2026

City

SPRING VALLEY

State

Zip

61362

County

BUREAU

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026