TRACY A ANDERSEN 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

TRACY

Middle

Last Name

ANDERSEN

Business Name

TRACY A ANDERSEN

Original Issue Date

07/26/2001

Effective Date

05/19/2025

Expiration Date

05/31/2026

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026