AMANDA J BASHAM Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****61

License Status

ACTIVE

Business

First Name

AMANDA

Middle

Last Name

BASHAM

Business Name

AMANDA J BASHAM

Original Issue Date

08/02/2022

Effective Date

09/09/2024

Expiration Date

05/31/2026

City

GRANITE CITY

State

Zip

62040

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026