MARY K CONKLEN Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****60

License Status

INACTIVE

Business

First Name

MARY

Middle

Last Name

CONKLEN

Business Name

MARY K CONKLEN

Original Issue Date

10/03/2002

Effective Date

08/24/2020

Expiration Date

05/31/2022

City

SPRINGFIELD

State

Zip

62791

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/24/2020